Erisa

Attorney representation in Atlanta, Georgia since the seventies

If you or a loved one has recently been denied a claim under a life insurance policy, that denial may well have been contrary to federal law. "ERISA" is an acronym for The Employee Retirement Income Security Act of 1974. This federal statute was intended to establish a set of minimum standards for employers who provide insurance to their employees, and to provide an effective level of legal protection for employees and former employees who are provided benefits. We represent survivors or beneficiaries who have been unfairly denied life or health insurance benefits.  Your denial of benefits may well have been contrary to the spirit and letter of the law.  If your  benefits are denied, appealing that decision administratively and then to federal court, required legal expertise.  At the law offices of R & K, we have the knowledge and skill to get an adverse decision reversed.

ERISA law is complicated. Over the years the scope of these laws has expanded to include such diverse legislation as the Consolidated Omnibus Budget Reconciliation Act (COBRA), the Health Insurance Portability and Accountability Act (HIPAA), the Newborns' and Mothers' Health Protection Act, the Mental Health Parity Act, the Americans With Disabilities Actand the Women's Health and Cancer Rights Act. There is an enormous body of case law interpreting these statutes.   Only an experienced Georgia ERISA claims attorney such as available to you at the law offices of R& K has the knowledge to sort through the specifics of your claim and decide whether you have a legal basis to object to the denial of benefits.  

For example, an employer may  offer its employees basic, supplemental and accidental life insurance policies through a life insurance company.  An employee may elect to obtain all of these.  Company benefit policies determine how much of the premiums are paid by the employer and how much by the employee, usually through payroll deduction.  If the employee dies while these coverages are in place, the insurance company may pay on all three policies, on none of the policies, or pay on one or two, but not the other.  On the accidental death policy, there may be a legal dispute about whether the death was accidental, especially if it involved an overdose or combination of  prescribed medication.   The company may deny payment based on a contractual  exclusion in the policy language, such as whether the death was caused by alcohol or recreational drugs.  When an insurer denies a claim, you should immediately seek professional legal help.  A successful appeal usually requires submission of medical and other records.  There are very complicated rules about what records and documents the insurance company and the employer must provide to you, and the time deadlines to do so.  The companies will not give you any documents voluntarily, especially if  help your appeal.  You have to know what to ask for, and how to legally require the production of documents.  If you do not timely request documents during the administrative appeal process, by the time you are allowed to file a lawsuit, it may be too late to get documents which help your case into the record.   The administrative appeal must be filed in a timely manner. Most importantly, the appeal will be the only opportunity that you, asa claimant, will have to submit all the substantive material necessary to prevail in that claim. If you are forced to go to Federal Court to litigate your claim, the court will review only such material as is on file in the administrative record of the insurance company. The opportunity to submit more supporting evidence will have been lost and has the potential to irrevocably harm your chance of success. For that reason the administrative record must be perfected to ensure that it is sufficient on its face to prevail in your claim. Perfecting an ERISA administrative record, given the elaborate array of statutes involved and the factual basis required to invoke the protection of those statutes, is no playground for amateurs. At the law offices of R & K, our Georgia ERISA law attorneys have the experience and skill to tune such documents to perfection so as to maximize the chance of success of your claim.

Most large, corporate insurance companies have their own in-house attorney teams who specialize in ERISA law claim management. Their mandate is to secure the bottom-line profitability of the insurance company. They recognize a perfected claim appeal record when they see it.  We can often negotiate a reversal of their initial denial of a claim and secure the benefits to which our clients are entitled.   We have had much success on behalf of our clients. It is our well-earned reputation and our aggressive willingness to go to Federal Court if necessary, that gets favorable settlements for our clients.  We can do the same for you.

At the law offices of R&K., our ERISA law attorney team specializes in representing survivors and beneficiaries who are unfairly denied life insurance or other benefits.  A strong personal commitment to the wellbeing of the many families that we have served over the years has characterized our practice of law since 1979 and our highest reward has always been the gratitude of the clients we have served. Remember that there is a time limit on your ability to file an appeal of a denial or an underpayment of benefits. We are toll free at (800) 475-6182 or locally here in Atlanta at (404) 477-0959.  We offer an initial consultation at no charge.

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