What Will The Claim Administrator Do To Investigate The Claim?
The insurance carrier can obtain your medical records, conduct a phone or an in-person interview with you, and conduct surveillance of your activities, both online and in person. Social media is one of the biggest ways they can conduct an investigation without even leaving their office. They can also send you to their doctor for a medical exam…Read More
How Does The Department Of Labor Enforce ERISA?
The regulations of an employee benefit plan are enforced through the Internal Revenue Code and ERISA. The two agencies that share responsibility for enforcing ERISA are the IRS and the EBSA, also known as the Employee Benefits Security Administration. Active enforcement activities include investigations, lawsuits, and the dissemination of information. Documents published by EBSA include the Reporting and Disclosure Guide for Employee Benefit Plans…Read More
What Are Possible Reasons To Sue A Plan Or Fiduciary Under ERISA?
The ERISA statute does have a civil enforcement scheme, which permits claimants to go to court. One cause of action under ERISA is a claim for benefits, which is frequently seen in long-term disability situations. There could be claims for breach of fiduciary duty, if the administrator failed to do something or did something that was not in the best interests of the plan. There could be a COBRA violation, if there is an issue with the health insurance plan, or a violation of the Anti-Interference or Anti-Retaliation Act provisions of ERISA, if you were retaliated against…Read More
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