On April 1, 2018, The Secretary of Labor’s (DOL) new regulations concerning review of ERISA claims went into effect. These new regulations were put into place to create a fairer system within the ERISA claims review process. “Limitations Periods” was one of the areas on which the DOL focused.
“Limitations Periods” refers to the time a claimant has to file an appeal, or bring a lawsuit after denial by the insurance company. Prior to the 2018 regulation changes, this issue often presented a problem for claimants. Because the time limitation to file an appeal or lawsuit was not always clear in the denial letter, many claimants did not file their appeals or lawsuits in time and were forced to forfeit their claims forever.
Typically, a claimant has 180 days to file an appeal following denial of an ERISA long-term disability claim. A claimant may also ask the insurance carrier for an extension of that time which may or may not be granted. Prior to the regulation changes in 2018, once the appeal was denied, the claimant would need to check the policy language regarding timelines to file a lawsuit and make a calculation of the time limitation. If miscalculated, the claimant may wait too late to file a lawsuit and waive their right to make any claim under the policy. Following the 2018 regulation changes, the insurance carrier is required to put a specific date on which the limitation period to file a lawsuit expires in the denial letter.
An ERISA long-term disability appeal needs to be carefully crafted in order to put all relevant information in front of the claims adjuster. In ERISA long-term disability cases, once the appeal time limitation is exhausted no additional information can be added to the claims file (also known as the Administrative Record). This means that if you file a lawsuit, only the information contained in the Administrative Record at the time of the final denial can be considered by the Court. Therefore, it is very important to craft an appeal that puts all relevant evidence before the claims adjuster.
If you believe you have been wrongfully denied your ERISA, or non-ERISA, long-term disability benefits, give us a call for a FREE lawyer consultation.
You can reach Cody Allison & Associates, PLLC at (615) 234-6000, or toll free (844) LTD-CODY. We are based in Nashville, Tennessee; however, we represent clients in many states (TN, KY, GA, AL, MS, AR, NC, SC, FL, MI, OH, MO, LA, VA, WV, just to name a few). We will be happy to talk to you no matter where you live. You can also e-mail our office at firstname.lastname@example.org. Put our experience to work for you. For more information go to www.LTDanswers.com