What is ERISA and how does it affect my insurance claim?
If you have insurance coverage that is provided for you by your employer, then the law that applies is more than likely the Employment Retirement Income Security Act (also known as “ERISA”). This federal law governs the duties owed to you by the insurance company. ERISA sets out certain standards for establishing, administering and maintaining most employee benefit plans. It was originally enacted by Congress to address public concern that funds of private pension plans were being mismanaged and abused. It has since been expanded to include health care and disability benefits. Although ERISA was designed to ensure that employees receive the benefits promised to them by their employers, unfortunately, the law has backfired. In a sense, it is now used to “protect” the insurance company when it does not pay your benefits. While the Act does provide certain guidelines and time frames that an insurance company must meet in order to process a claim for benefits, it doesn’t allow the average
