Differences Between ERISA and Individual Long-Term Disability Plans

Employees Retirement Income Securities Act (ERISA) are group disability policies composed of complex federal and state laws. Individuals generally have ERISA disability policies provided by their employer. Other long-term disability plans offered by government or state employers do not have to be associated with ERISA.


Individual LTD Plans

How Can You Appeal ERISA and Individual LTD Plans That Deny a Claim?


If a person’s insurance carrier responsible for their LTD policy denies their claim, they can file an appeal within six months from the date of denial. Medical evidence completely supporting the person’s disabling condition will need to be gathered and submitted along with the appeal letter. Presenting well documented ERISA and individual LTD policy appeals is essential to winning approval following a denial.


The biggest difference between filing an ERISA LTD policy lawsuit and filing an individual disability policy is that ERISA claimants are not entitled to jury trials. ERISA lawsuits are resolved by judges only, with the majority of decisions made through filing of summary judgment motions. Alternately, individual disability lawsuits are almost always heard before a jury who determines that lawsuit’s resolution.


What Awards are Given After Winning an ERISA or Individual LTD Plans Appeal?


People winning an appealed ERISA case in federal courts are typically not granted awards of attorney fees. Claimants appealing and winning an individual LTD policy denial may be awarded attorney fees based on state laws. Some states do not permit awarding of attorney fees in long-term disability lawsuits.


ERISA guidelines do not allow claims involving punitive or “bad faith” damages against an insurance agency’s wrongful denial of LTD benefits. When disability insurance companies lose ERISA lawsuits, they typically have to pay past due disability benefits, attorney fees and possibly, an interest amount determined by the presiding judge.


If you have been denied by your ERISA or long-term disability insurance company, you may have a claim based on bad faith. This means your insurance company has denied your claim without merit. Contact London Eligibility today to make an appointment with an experienced disability lawyer who may be able to appeal and win your case.