Denial of Benefits

The law does not require an employer to offer benefits. However, a federal law called the “Employee Retirement Income Security Act” (ERISA) does require employers to fairly administer benefit programs for pension, retirement, health and disability in accordance with the terms of the programs. While some large employers may self-fund these programs, more often the programs are offered through and administered by insurance companies. Often, it is the insurance company that will determine whether or not you meet the eligibility for short-term disability, long-term disability, or certain pension, retirement, and medical benefits.

When plan administrators deny benefits, it can have a devastating financial and emotional impact on the employee and family members. ERISA requires the employee to appeal the denial first through the insurance company or self-funded plan’s own internal appeal procedures before they may file a lawsuit in federal court. Employees fighting for medical benefits should not do so on their own and can turn to Scott Fegley to help them battle the insurance companies. Mr. Fegley has the experience to identify claims handling errors, obtain the proper medical documentation of a disability, and compel the insurance company to approve or reinstate benefits often in the internal appeal process saving the client the further lengthy delay and expense of a lawsuit.

If you have been denied benefits, or had them terminated, please contact us or give us a call at (215) 493-8287 to schedule a free consultation. Mr. Scott Fegley will personally discuss your situation with you by telephone or email and will tell you whether you may be entitled to the benefits.