The Employee Retirement Income Security Act (ERISA) is a federal law that applies to a number of private, employer-sponsored benefits plans (i.e., retirement income, healthcare, disability, etc.). Though not all employers are required to offer a qualified plan, those who do must meet the requirements imposed on them by ERISA — from disclosure rules, to procedural rules, to fiduciary duties, and more. For example, if you have filed a disability claim with your employer-sponsored plan, then the insurer must process your claim in a reasonable, timely manner and in accordance with ERISA regulation.

Appeal Process

If you have submitted an ERISA claim and the insurer denies benefits, you will have the opportunity to file an appeal and support your original claim by gathering a more comprehensive documentary record, among other evidence. Various procedures will have to be followed to ensure that you are not in violation of ERISA procedural regulation. If the appeals process is unsuccessful, however, you may be entitled to file a lawsuit against the insurer on the basis that the defendant-insurer breached the insurance contract or breached its fiduciary duty to you in denying your benefits. The Houston ERISA class action attorneys at Berg Plummer Johnson & Raval, LLP are prepared to assist you should filing a lawsuit become necessary.

Our Houston ERISA Class Action Attorneys Can Assist With ERISA Claims

There are a number of different claims that can be brought against the insurer for violation of ERISA regulation. Two common ERISA causes of action are denial of benefits (section 502(a)(1)(B)) and breach of fiduciary duty (section 502(a)(3)). For example, if you are an employee whose plan assets have been mismanaged by the insurer, you may be entitled to sue the defendant for breach of fiduciary duty under section 502(a)(3) of ERISA.

Pleading an ERISA Class Claim

Class actions are the best means for asserting the common interest of all participants in the action. In fact, ERISA breach of fiduciary duty claims often require class certification to proceed, as all other plan participants are necessarily co-plaintiffs if the insurer has breached their fiduciary duty to the participants. On the other hand, denial of benefits causes of action are less likely to lead to class action lawsuits, given the personalized nature of the claims process — though there may be a viable class action lawsuit if there is evidence that the insurer consistently and systematically denied claims against participants.

ERISA class actions, just like other class actions, are brought by a plaintiff on behalf of a larger group of plaintiffs (i.e., a class). ERISA claims can be challenging to litigate, and that is especially true of class actions. Though ERISA was originally intended to safeguard the interests of employees tied to an employer-sponsored benefit plan, ERISA tends to emphasize out-of-court resolution as opposed to litigation — there is no jury trial, no state trial, and damages may be substantially limited (there are no consequential or punitive damages), among other limitations.

Given these difficulties, it’s important that you work with an ERISA attorney who has experience litigating both individual and class action claims on behalf of employees. Here at Berg Plummer Johnson & Raval, LLP, our Houston ERISA class action attorneys bring to bear decades of experience successfully representing employees in ERISA actions. Call us at (713) 526-0200 or contact us online to schedule a consultation.

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