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DATE POSTED 03. 08. 2017, By

Have You Been Denied Life Insurance Benefits? Our ERISA Attorney Is Here To Help

Life insurance provided through your spouse’s employer can prove invaluable in helping your family in the event a tragedy occurs. While no amount of money can make up for the loss of your loved one, life insurance death benefits can help to replace lost wages while alleviating financial concerns as you recover. When these benefits are disputed or denied, Roberts Bartolic, LLP, is here to help. With over a decade of experience as ERISA claims attorneys, we can help guide you through the process of appealing a denied claim, so your family can get the benefits your loved one would want you to have.

Life Insurance Benefit Denials

Life insurance plan benefits provided through an employer sponsored plan are subject to the Employee Retirement Income Security Act of 1974 (“ERISA”). This requires employers to thoroughly disclose to plan participants the types of benefits offered, as well as the terms under which they are paid. It holds employers accountable as fiduciaries with a duty to protect the employee’s interests in managing any retirement funds or health and life insurance policies, and provides a grievance procedure when claims are mismanaged, reduced or denied for unauthorized reasons.

There are several common reasons as to why a life insurance company might deny a policyholder’s claim:

  1. Policy premiums were not properly paid.
  2. The proper documentation of the death and the reasons for it were not submitted.
  3. The cause of death is not covered by the policy.
  4. The policyholder misrepresented themselves or lied in filling out the policy application.

When life insurance benefits are denied, you are entitled to be informed of the exact reason for the denial, and must be given a time period in which to appeal the decision.

Appealing A Denied Life Insurance Claim

Under Department of Labor (DOL) guidelines in appealing decisions related to benefits that are covered by ERISA, insurance companies must notify you of decisions regarding your claim within 90 days of filing. If your claim is denied or disputed, you must be given a minimum of 60 days in which to file an appeal.

When appealing denied life insurance benefits, our experienced ERISA attorneys can help guide you in the information you need to provide. Depending on the situation, this may include:

  • Copies of the death certificate and related documents;
  • Health records and statements from medical providers;
  • Statements from experts regarding the underlying cause of death and contributing factors;
  • Testimony from family members, friends, and anyone who provided care or has relevant information regarding your loved one’s final days.

Once an appeal is filed, it must be given a full and fair review, and a decision must be rendered in 120 days. If your appeal is denied, you may be entitled to seek benefits through a lawsuit filed against the life insurance company, or against the fiduciary of the benefit plan. Call or contact Roberts Bartolic, LLP online immediately at the first sign of a delay in payment or the denial of a claim. Our Chicago ERISA benefits attorney provides the experience and support your family needs during this time, to help ensure you get the benefits you are entitled to.

 

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