ERISA Attorney Serving San Francisco

ERISA was initially enacted in the 1970s to protect pensioners whose funds were being looted by the fiduciaries responsible to protect them. Unfortunately, the complicated federal statute, and the legal cases interpreting it, have become a shield that virtually immunizes insurance companies against liability for bad faith claims practices. The ERISA experts at The Grey Law Firm, PC, understand how to use every possible legal resource to level the playing field to maximize the recovery of your benefits under ERISA.

San Francisco Bay Area Long-Term Disability Lawyer

With some exceptions, ERISA applies to claims that arise out of insurance provided by an employer, including health, disability, life and Accidental Death and Dismemberment (AD&D) coverage. What many people don't know is ERISA severely restricts the remedies available in the case of an improper denial. Under state insurance laws, a wronged insured can pursue the full panoply of legal remedies, including back benefits, future benefits, consequential monetary damages, emotional distress damages, attorneys' fees and punitive damages. Under ERISA, claimants are limited to back benefits and a potential court award of attorneys' fees at a judge's discretion.

Whereas under state law, insureds may pursue a claim against an insurance company through a trial after conducting discovery, ERISA severely restricts and in some cases prohibits discovery, leaving only the documents originally submitted to the company as the entire record. There is no jury trial or right to call witnesses, but rather the determination is made by a judge who reviews only the documents in the original claim file.

To make matters worse, some policies contain language that provides "discretion" to the insurance company which in effect requires judges to give extra weight to the insurance company determination, even where the judge disagrees with it. Although insertion of so-called discretionary language in policies issued to California insureds has been prohibited by state law, many insurance companies continue to contend their decisions are entitled to discretion.

One of the most important ways The Grey Law Firm, PC, can help you is to assist you with an administrative appeal of a wrongfully denied or terminated ERISA claim. It is crucial to consult with an ERISA expert because an administrative appeal is required before filing suit. More importantly, the record created in that appeal may be the only record reviewed by a judge should litigation be necessary. Therefore, an administrative appeal is often the claimant's last chance to make sure all the relevant information is in the file before the claim proceeds to litigation.

Insurance companies have effectively exploited the many pitfalls ERISA presents to the unwary and unrepresented. At The Grey Law Firm, PC, we use every aspect of ERISA and its governing regulations in your favor in order to make our clients whole. Not only are we determined to protect your rights, but we have the experience and ability to do so.

Contact A California Disability Benefits Attorney

Speak with an experienced San Francisco ERISA lawyer for assistance with your legal questions by calling The Grey Law Firm, PC, at 415-766-0653. You can also contact us online to schedule a free initial consultation that is completely confidential and entirely discreet.