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Handling the Conditions of ERISA for Long Term Disability

By Edited May 5, 2015 0 0

The ERISA or the Employee Retirement Income Security Act was enacted in 1974 to benefit employees who acquire disability while they are employed in a company. This act was quite helpful in its first few years. The ERISA regulated the benefits that workers deserve to get from their group insurance policies, which their employers have purchased for them. However, through the years, it seemed it has changed sides.

Employees today are now complaining that the ERISA is not protecting their interests and welfare anymore. This is because it prohibits employees to file cases for denied insurance claims in state courts. Instead, all their complaints should be filed and processed in federal courts. If the complainant fails to show enough evidence, he would lose the case even if the insurance company was terribly wrong denying his disability claim. Pretty unfair, isn't? If you want to avoid these unfortunate circumstances, follow these guidelines:

  • If your employer provides you an insurance coverage as part of your employment contract, read and understand its conditions carefully – This would inform you the specific conditions that would allow you to receive benefits.

  • Anything related to your disability claim should be documented, recorded, or kept for future use.

  • Talk with the insurance provider and clarify certain factors related to your policy – You should know if the insurer provider can indeed deliver in times of need.

  • Consult an attorney who is an expert when it comes to ERISA conditions – He would help you understand the ERISA and provide you ideas on what you can do to deal with it.

  • Keep yourself safe and stay away from accidents – If you get involved in a "clumsy" accident, the insurance company might not pay you because you were negligent of your safety.

  • Get a private insurance policy – Employees with privately-purchased insurance policies are not covered by ERISA.

It would be important to point out that ERISA only covers employees of privately-owned companies and workers who have group insurance policies purchased by their employers. If you are working in a government agency or department, the ERISA cannot force you to submit your denied claims to federal courts.
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