Lawyers handling Employee Retirement Income Act (ERISA) cases will tell you that the answer to the above question is … nothing happens. Generally, the United States Supreme Court has not allowed any remedy that is not clearly expressed within ERISA’s provision 29 U.S.C. Section 1132. Section 1132 allows for injunctive…
The Employee Retirement Income Security Act (ERISA) is governed by federal statutes. The claims procedures originate from 29 U.S.C., Section 1133 and 1135. Section 1133(1) requires that a carrier or claims administrator provide adequate notice of the reasons for denial that can be readily understood by the claimant. Section 1133(2)…
Employee Retirement Income Security Act (ERISA) issues can be more onerous than most people can imagine. Most people who get their insurance from work do not think about it except the the extent of how much it costs, the extent of coverage, and which providers are in the network. Rarely…
The Employee Retirement Income Security Act, otherwise known as ERISA provides for insurance benefits that are vital to claimants and their families. An ERISA claim denial means that the claimant did not receive the medical treatment, disability income, life insurance or retirement benefits that the claimant expected under the plan. …
Who is entitled to life insurance benefits is not always an easy answer. The designated beneficiary of a life insurance policy generally is entitled to the proceeds upon the death of the insured. Absent an adverse claim, the insurer may pay the benefits to the designated beneficiary. This is not…
Pinning down the exact date coverage begins can sometimes be a tricky proposition. If an insured dies before a policy becomes effective, there is no coverage. This was discussed in the 1950, Texas Supreme Court opinion, Republic National Life Insurance Company v. Hall. and the 1980, Eastland Court of Appeals…
Life insurance lawyers will see many reasons for denial of life insurance benefits. Occasionally, one of the reasons is that the policy had not become effective at the time of death. Most policies state the “effective date” of coverage. This date may be earlier than, or later than, the date…
Almost all auto policies will have a form to fill out called a 515A. This form when filled out and signed excludes named drivers from any coverage while they are operating the otherwise insured vehicle. This topic was discussed in a declaratory judgement opinion from the Dallas Court of Appeals…
The U.S. District Court, Eastern District, Sherman Division, issued an opinion in May 2018, styled, James Cunningham and Tabatha Cunningham v. Allstate Vehicle and Property Insurance Company. The Cunningham’s allegedly suffered damages during a hail and windstorm. The claim was reported to Allstate and five days later Allstate inspected the…
ERISA cases are complicated, as any attorney handling ERISA cases can tell you. This is exemplified in an April 2018, opinion from the U.S. District Court, Western Division, Austin Texas. The opinion is styled, Kimberley Phillips v. Charter Communications, Inc. Welfare Benefit Plan. Charter filed a motion to transfer the…