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.

Why Do Insurers Deny Long-Term Disability Claims?

Long-term disability claims are denied for a variety of reasons and some of those reasons include failure to satisfy the eligibility factors in the plan, failure to establish the definition of disability, and the carrier’s pursuit of its own monetary interests over its fiduciary duty to the claimant.

Will I Be jeopardizing My Employment By Pursuing An ERISA Claim?

If an employer retaliates against an ERISA participant, that may implicate the Anti-Retaliation provision of the statute. However, most policies are insured. In that case, the lawsuit is not against the employer but against the insurance carrier. In that scenario, the employer may not have any interest in the dispute. On the other hand, there are some scenarios where the benefits are provided by the employer. In that case, you are suing the employer. However, you do still have the protection of the Anti-Retaliation section of the statute.

Can I Sue And Recover Damages If The Fiduciary Has Mismanaged My Benefits?

A fiduciary who has mishandled plan benefits can be sued. However, the damages are severely limited by the statute and the case law. Generally, the only benefits that can be recovered are plan benefits. The only remedies available are equitable remedies. The ERISA participant who uncovers a fiduciary breach is not entitled to punitive damages, treble damage, or compensatory damage. Rather, the available remedies include restoration of benefits, interest, attorneys’ fees, and possible equitable surcharge.

For more information on Suing A Fiduciary Under ERISA, a free initial consultation is your next best step. Get the information and legal answers you are seeking by calling (352) 577-7746 today.