Philadelphia ERISA Attorneys Investigating Employee Benefit Claims
Pension plans, health plans and employment-related compensation are challenging topics to work through. These difficulties are magnified if you are wrongfully denied health benefits or were terminated for attempting to get benefits. The knowledgeable attorneys at Karpf, Karpf & Cerutti, P.C., have helped clients throughout New York, New Jersey and Pennsylvania.
How ERISA Protects Your Employee Benefits
The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that establishes minimum standards for most voluntarily established retirement and health plans in private industry. This law does not require employers to provide benefits, but it does protect workers when a company chooses to offer them. It ensures that plan holders provide participants with essential information about plan features and funding. ERISA outlines fiduciary duties, requiring managers to act solely in the interest of plan participants and for the exclusive purpose of providing benefits.
ERISA covers a wide range of employee benefits, including:
- Retirement and pension plans
- Health insurance and disability coverage
- Life insurance and death benefits
- Certain types of funded vacation benefit trusts
- Severance policies that require ongoing administration by the employer
- Profit-sharing and 401(k) plans
When an insurer or provider denies your claim, our attorneys can challenge that decision. We gather medical evidence and job records to build a strong appeal. Our team communicates directly with insurers to resolve disputes, and if your claim is denied, we help you navigate the mandatory internal appeal process and, if necessary, file a lawsuit in federal court to enforce your rights.
Do You Have An ERISA Violation Claim?
Our attorneys fight to protect the benefits you earned. With over 100 years of combined experience, we provide the skills you need to pursue your case effectively. We assist clients in many situations, including:
- Wrongful denial of health or disability benefits
- Unpaid severance based on company policy
- Retaliation for asking about your benefits
- Termination intended to prevent you from getting benefits
- Misrepresentation of your benefit plan
This area of law is complex, but we examine every option to find a solution. You have legal rights, and we provide an honest assessment to help you enforce them.
Key Questions You Can Ask About Your ERISA Benefits
When you are dealing with an ERISA benefits dispute, knowing what to do next can help you protect your rights. These common questions cover important steps, deadlines and considerations during the claims and appeal process.
What should I do immediately after receiving an ERISA benefits denial letter?
Read the denial letter closely and note each reason for the denial. You will need to address each reason in your appeal. Request your full claim file from the plan administrator as soon as possible. Gather medical records, employment records and other evidence that may support your appeal and mark the appeal deadline so you do not miss it.
Can I file a federal lawsuit right away or must I complete an internal administrative appeal first?
Before bringing an ERISA claim in federal court, you typically need to finish the appeal process offered by your plan. This is known as the doctrine of exhaustion of administrative remedies. Skipping the appeal could lead to dismissal of your case. Once you receive a final denial, you may be able to bring your ERISA claim in federal court.
How much time do I have to appeal a denied ERISA disability or health insurance claim?
Generally, you have 180 days after receiving the denial notice to challenge a denied disability or health benefit claim. Your plan documents and denial letter should state the deadline that applies to your claim. After you complete the appeal process, a separate deadline may apply to a federal lawsuit. Consider confirming both deadlines with an attorney as soon as possible.
Is it illegal for my employer to fire or discipline me to prevent my benefits from vesting?
ERISA Section 510 prohibits an employer from firing, disciplining or otherwise interfering with you to prevent your benefits from vesting or to stop you from receiving benefits. This protection can apply to pensions, health benefits and other ERISA-covered plans. If you believe this occurred, document the events and timing, since evidence of intent can be important to your claim.
Why is it critical to hire an employment attorney during the administrative appeal phase rather than waiting until a lawsuit is filed?
Hiring an employment attorney can be helpful during the administrative appeal, not just after a lawsuit begins. The appeal may be your main chance to build the record that a court later reviews. Our attorneys can help you gather medical and vocational evidence and present legal arguments while the record is still open.
Taking these steps early can help you avoid missed deadlines and preserve important evidence for your ERISA benefits claim.
Learn More During A Free Consultation
Our attorneys are here to answer your questions and address your concerns. To schedule an initial consultation with one of our attorneys in Philadelphia or Bensalem, call us at 215-639-0801. To call someone on our team in our Marlton or Astoria office, contact us at 609-683-4022. You can also fill out our contact form to reach us online.