ERISA can provide many important protections for workers with concerns about their insurance and insurance claims that are being unreasonably delayed or denied. ERISA stands for the Employee Retirement Income Security Act and is important for insurance claimants to be familiar with.
What ERISA does
The Employee Retirement Income Security Act (ERISA) provides minimum standards for the administration of private industry pension plans. It is a federal law that sets minimum standards for private industry retirement and health plans that provides protection for workers covered by the retirement or health plan.
ERISA requires that plan participants are provided with certain information including information about the features of the plan and how the plan is funded; establishes fiduciary duties for those who manage and control plan assets; requires that the plans establish grievance and appeals processes for participant to obtain benefits from their plans; and provides plan participants with the right to sue for benefits or breaches of fiduciary duties.
When a claimant believes their claim has been unreasonably delayed or denied, ERISA may provide important protections to the claimant that they should be aware of. ERISA provides a cause of action for employees and their beneficiaries to bring a claim if their benefits are wrongfully denied. Many employees and their families likely rely on their health care benefits during one of the most difficult times in their lives when they are facing a health-related challenge. For that reason, they should be familiar with how ERISA and other insurance law resources may be able to help them if they are facing the unreasonable delay of their claim or a bad faith denial of their claim.