Do You Know the Deadline for Filing Your ERISA Claim? Even if You Think You Do, You May Be Wrong
While ERISA claims come with many obstacles, one of the most challenging is a disability insurance company’s right to shorten their plans’ appeal deadlines. Unfortunately, courts won’t give disabled workers and professionals who miss these deadlines much (if any) leeway.
Unfortunately, once a deadline expires, it’s usually too late, and you’ll lose your right to benefits. The team at Bryant Legal Group is happy to meet with people who have missed their appeal deadline and will be there to guide them as they take the next steps.
Below, our experienced ERISA lawyers discuss the essentials of plan limitation periods and explain how you can protect your legal rights.
The Essential Steps of an ERISA Appeal
ERISA appeals follow a different process than most insurance-related claims. With ERISA, you can’t just file a lawsuit if your employer-funded plan denies a benefit claim. Instead, you must:
- File an administrative, or internal, appeal with the insurance company (usually within 180 days of your denial)
- Participate in the insurance company’s review process and submit additional evidence
- Wait for the insurance company’s final decision, typically within 45 to 90 days
- If denied again, file a lawsuit in federal court
In general, the law says you must “exhaust your administrative remedies” before you file an ERISA lawsuit, and the steps above meet the court’s definition for exhausting available remedies. If you submit a claim before you complete the above process, the courts will most likely reject your case.
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However, if you wait too long, you’ll lose your right to benefits. Like all legal actions, there are strict filing deadlines that govern ERISA appeals — but unlike with most contract disputes, the deadline can vary from plan to plan in an ERISA claim. Bryant Legal Group is available to help you pin down your filing deadlines so you can relax and move forward with your life.
- Related Article: 5 FAQs About Private Disability Insurance Claims
ERISA Does Not Have Its Own Statute of Limitations
Unlike most legislation, the ERISA statute does not contain a statute of limitations; in other words, the law for ERISA doesn’t specify exactly how long you have to file a claim. However, this doesn’t mean there is no statute of limitations for ERISA claims. Instead, the time frame for filing an ERISA claim varies from state to state. In Illinois, the courts use a 10-year statute of limitations.
RELATED ARTICLE: What Does It Mean to Exhaust Your ERISA Administrative Remedies?
If that wasn’t complicated enough, insurance companies can also change the deadline for filing claims in their plan documents. So, even if you know the statute of limitations for ERISA claims in your state, you can never assume that it applies. To figure out the true deadline for filing your claim, you’ll need to obtain a copy of your plan document and consult a lawyer as soon as possible.
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U.S. Supreme Court Says Plan Documents Can Shorten Statute of Limitations for ERISA Claims
It’s not uncommon for insurance companies to shorten the state’s default statute of limitations within their plan documents. While many claimants and their attorneys have argued that plan-designated limitation periods go against public policy, the courts have rejected these arguments.
In 2013, The U.S. Supreme Court upheld a plan’s three-year limitation period that began to run before the insurance company issued a final decision approving or denying benefits in Heimeshoff v. Hartford Life & Acc. Ins. Co. In this case, the plan document clearly stated that disabled workers had to file a federal lawsuit no more than three years after their proof of loss was due. Unfortunately, the claimant, Ms. Heimeshoff, was not aware of this deadline. Instead, she filed her lawsuit based on a deadline of three years from her claim’s final decision, which would have been the correct deadline according to state law.
When Ms. Heimeshoff filed her lawsuit, the insurance company asked the court to dismiss her claim due to the late filing. Both the trial and appellate courts sided with the insurer.
Eventually, the case made its way to the U.S Supreme Court. In a unanimous decision, the Supreme Court held that while ERISA appeal rights do not activate until the insurer makes a final decision, the limitation period can start to run before that date if the time frame is reasonable and does not conflict with a controlling statute.
In Ms. Heimeshoff’s case, she had roughly one year to file her lawsuit after the company made its final decision. The Court found that this was a reasonable amount of time to file a lawsuit and did not identify any state or federal statutes of limitations that conflicted with the shortened limitation period.
The Supreme Court’s decision also emphasized that the plan’s language is at the heart of all ERISA claims and that courts should typically enforce a written contractual limitation period.
RELATED ARTICLE: What Makes ERISA-Covered Plans Unique?
How Can I Protect Myself Against Shortened ERISA Filing Deadlines?
When it comes to ERISA filing deadlines, knowledge is power. Before you apply for benefits, you should:
- Request copies of your plan document and summary plan description (SPD)
- Review these documents carefully and note deadlines in your calendar
- Read any correspondence you get from the insurance company and store the letters in a safe place
- Consult an experienced ERISA lawyer
Most people can’t interpret an ERISA plan document on their own since these documents contain highly complex structure and language. If you need help understanding your plan’s requirements and your legal rights, contact Bryant Legal Group to schedule your free consultation with an experienced attorney.
Bryant Legal Group: We Stand Up to Insurance Companies
If you’re unable to work and have questions about a disability insurance claim, Bryant Legal Group would love to hear from you. Our team of experienced ERISA lawyers guides disabled individuals and their loved ones through the ERISA application and appeal processes so they can go forward with confidence.
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