It happens all too often: someone sustains an injury or is stricken with an illness that renders them unable to work. They file their claim for disability benefits and the insurer denies it, or pays it for a period of time and then terminates their claim under the Employee Retirement Income Security Act, known as ERISA.
What Is ERISA?
ERISA is the federal law that sets minimum standards for most voluntarily established employee benefits in private industry, and provides protection for the individual employees covered under these plans. It was originally written to protect employee benefits from the actions of unscrupulous private companies. It also covers the benefits that are funded and paid by insurance companies, which routinely manipulate ERISA to deny, delay, and terminate claims.
This is intimidating and uncharted territory for most disabled employees. If it’s reminiscent of your experience, you should contact Schwartz Law. We’ve been navigating this complex area of law for decades and continually break new ground to help people like you.
How Schwartz Law Can Help
For many policy holders, denied disability claims can be earth-shattering. This is the time policy holders need their benefits the most, because they are sick or injured and their regular income has decreased or ceased altogether. Schwartz Law has represented thousands of clients in the claims and litigation processes, fighting to ensure that insurance companies cannot rely upon the intricacies of ERISA to deny or withhold benefits.
Though your injury may be instantly recognizable, the symptoms it can cause are not always so obvious. It can be difficult to prove these issues and link them to your inability to work. These issues are often contested by insurance companies, but we have the talent and experience to prove their impact on your ability to work, and the pain and limitations they cause.
Schwartz Law has skilled lawyers and staff with decades of collective experience handling the following types of ERISA matters:
- Claims Submissions
- Claims Management
- Appealing denied/terminated claims
- Lawsuits or litigation
- Settlements before and during lawsuits
Our Successful Track Record
Some of our cases have changed the law and garnered major payments, awards and settlements on behalf of clients whose claims were denied or terminated.
Connors v. Connecticut General Life Insurance Co. is a case that has set the industry standard. Evan Schwartz persuaded a federal appeals court to rule for his client, stating that insurance companies cannot ignore the subjective complaints of pain and disability claimed by the insured, and must give those complaints substantial weight when deciding whether the insured is disabled.
In Keir v. UnumProvident Corp., Evan Schwartz and his firm used ERISA as a tool to bring the first nationwide disability claims practices class action against an insurance company regarding the manner in which they denied and terminated long-term disability claims. The complaint and lawsuit has set a nationwide precedent for lawyers for 15 years.
In Mossa v. Provident Life and Casualty Insurance Co., Evan Schwartz and his firm set a precedent preventing insurance companies from denying payments under policies containing an “any occupation” clause. The ruling changed the legal definition of “any occupation,” and compels insurers to pay benefits if policyholders can’t obtain a job earning income in line with their salary history. This protects an individual’s standard of living while they collect disability payments and substantially lengthens their receipt of benefits.
These cases and rulings, among others, shaped the law under ERISA to help people like you receive benefits everywhere in the United States.
Our Promise Is To Make Insurance Companies Keep Their Promises
Generally speaking, the law under ERISA is far less helpful to the insured individual than it is to insurance companies. You need seasoned professionals to advocate for you, in and out of the courtroom, to get the benefits you need following an injury or an illness. With Schwartz Law in your corner, your insurance company will keep its promises to you.