Call for a FREE Consultation

Offices in NY & NJ

10 Things You Should Know About ERISA Insurance Benefits
22August 18

10 Things You Should Know About ERISA Insurance Benefits

ERISA Insurance Benefits in New JerseyWhen most folks think of ERISA, they think of IRAs and 401ks. ERISA also covers disability insurance. If you become unable to work for any reason, your expenses don’t just go away. It is possible to invest in an LTD (long-term disability) plan that covers this potential circumstance. Here is everything you need to know about an ERISA insurance plan.

1. Look at How Your ERISA Insurance Policy Defines Disability

Insurance companies love to sell you on peace of mind, but an insurance policy is not there to give you comfortable feeling. It’s supposed to kick in when you’re unable to work. Some policies define the term “disability” so narrowly that it becomes rare that any injury would rise to the standard of a “disability” as defined in the insurance policy.

Other policies will state that the insurance policy pays out when you can no longer perform the duties of your current job. After a period of time, however, these same insurance policies will only pay out in the event that you cannot work at all or perform “any” job.

This is one instance where you want to read the fine print.

2. There’s a Waiting Period for Your ERISA Insurance

Waiting periods of between 3 and 6 months are not uncommon. Those who are disabled are expected to use up all of their short-term disability, sick time, and whatever other benefits they have before their LTD kicks in.

3. Is Your ERISA Insurance Stipend Taxable or Not Taxable

Whether or not your monthly stipend is taxable depends heavily on the type of plan you have. Group plans are generally paid into with untaxed money and then taxed on their way out of the account. There are, however, plans in the style of Roth IRA’s that are not taxed on their way out.

4. Prepare to Be Under Surveillance

Insurance companies will hire private investigators to conduct surveillance on those claiming long-term disability benefits. This is especially true for claims that may not have specific medical proof. A claim such as fibromyalgia is diagnosed based on exclusion and identifying pain points on the body. There are no MRI’s or other laboratory tests to prove or deny such a diagnosis. It is not uncommon for insurance company PI’s to stake out a claimant’s house, follow them to the grocery store, or attempt to interact with in an effort to deny their claim.

5. The Insurance Company May Require You to Apply for SSDI

As part of your policy, you may be asked to apply for SSDI. Why pay out on a policy if you can have the general public do it for you? Whatever money you get from SSDI is then deducted from your disability insurance.

6. ERISA Insurance Benefits Pay You a Percentage of Your Salary

In other words, LTD benefits do not pay you the entire amount of what you used to make, but only a percentage. There is a chance that what you’re paid will not cover your expenses and a greater chance that you will not live comfortable on your stipend.

7. Many ERISA Insurance Claims Are Denied

The plan’s structure and wording often are designed to deny claims. That doesn’t mean that your claim is legally deniable. You can file for an appeal and have a lawyer represent your interests.

8. Not All Disability Claims Pay Out Over the Same Period

While some LTD benefits pay out until you’re retired, others only pay for 5 or 10 years depending on the policy.

9. Psychiatric Conditions Have Shorter Pay Periods

Depending on your policy, a psychiatric condition such as depression, anxiety, or bipolar disorder may only pay out for 24 months.

10. Medical Evidence Is Crucial to Your Claim

As soon as you file a claim, your insurance company is looking for any reason to deny it. Insurance companies are for-profit businesses and they turn a profit by not paying out on claims. Nonetheless, their hands are tied in the face of well documented medical evidence.

Talk to your doctor if you plan on filing a disability claim. The insurance company will send them a packet to fill out regarding your medical history. When the two of you are on the same page the process goes much smoother.

Contact an ERISA Attorney Today

If your insurance company denies your claim, and ERISA attorney at Uscher, Quiat, Uscher & Russo, P.C. may be able to help. Call us today to discuss what evidence you need to prove your ERISA insurance claim.

Request a
Free Consultation

What Our Clients Say

  • Mr. Quiat was very specific about my options, chances of a successful appeal, and the costs of same. We did discuss the possibility of taking […]

    ~ Kevin

    unum disability claims
  • Mr. Quiat, and his Team were able to re-instate my disability benefits discontinued by Aetna Insurance. Mr. Quiat was always available, and responded quickly to […]

    ~ Carlos

    unum disability claims
  • Mr. Quiat . Is thorough , pleasant to work with . He exhibits complete competency of his profession . I would highly recommend him . […]

    ~ Insurance Client

    unum disability claims
  • Mike took the time in our initial meeting to truly understand my situation and what I was up against. He listened to my concerns and […]

    ~ Kevin

    unum disability claims
  • As I was facing some of the most difficult times of my life with seemingly no way out, I was most fortunate to meet Michael […]

    ~ Long Term Disability Client

    unum disability claims
  • HE IS THE BEST!!!! He listened very intently to me and took copious notes. At the end of my meeting with him I knew that […]

    ~ Arbitration Client

    unum disability claims
  • GREAT ADVOCATE, CARING, HIGHLY ATTENTIVE, NOT GREED DRIVEN.
    Michael Quiat handled my long term disability case and did so in a very caring manner. […]

    ~ Barbara

    unum disability claims
  • TOP OF THE LIST OF ATTORNEYS Mr. Quiat responded to all of my phone calls and emails in a timely manner. Mr. He is very […]

    ~ Insurance Client

    unum disability claims
  • SOLID EXPERTISE Solid expertise… Very responsive in client concerns\Effective advocate in handling interactions with opposing party.

    ~ Employee Benefits Client

    unum disability claims
  • THE MOST RESPONSIVE ATTORNEY Mike stands out as the most responsive attorney…He always made it as easy as possible for me to get things done, […]

    ~ Insurance Client

    unum disability claims
  • EXTRAORDINARY ATTORNEY Mike Quiat is an extraordinary attorney…His extensive experience and expertise was instrumental in obtaining and maintaining my LTD benefits… The compassion he showed […]

    ~ LTD Client

    unum disability claims
  • WE NEVER HAD TO GO TO COURT Mr. Quiat took over the case, and, due to a combination of his meticulous attention to detail in […]

    ~ Insurance Client

    unum disability claims
  • EXCELLENT!They were very professional, responsive to my questions, and successfully represented me with my claim. I would highly recommend Michael Eli Quiat and Joe Russo […]

    ~ LTD Client

    unum disability claims
  • WELL PREPARED AND PRESENTED Mr. Quiat’s appeal on my behalf was so well prepared and presented there is no doubt something like this is best […]

    ~ Insurance Client

    unum disability claims
  • MIKE GOT RESULTS I’ve worked with many attorneys over the course of my business career. Mr. Quiat is not only knowledgeable and capable, but also […]

    ~ Insurance Client

    unum disability claims
  • WE SUED AND WON… My disability insurance company stopped paying me. We sued and won and Mike got my payments reinstated… I trusted Mike completely, […]

    ~ Insurance Client

    unum disability claims
  • GENUINE CONCERN FOR THE CLIENT I have personally seen Mike Quiat in action on ERISA long term disability cases. Mike takes a personal interest in […]

    ~ Insurance Client

    unum disability claims
  • I NEVER HAD A PROBLEM… I have found him to be experienced, knowledgeable, but not over-bearing … I never had a problem getting appointments, reaching […]

    ~ Employee Benefits Client

    unum disability claims
  • THE HIGHEST REGARD… Michael and his staff have always been very professional, polite, and well informed. … I have nothing but the highest regard for […]

    ~ Contracts Client

    unum disability claims
  • RESPECT AND COMPASSION… I was very scared, anxious, intimidated and unsure of how to handle a particular disability insurance claim with a big company.Mike immediately […]

    ~ Arbitration Client

    unum disability claims
  • “CAN DO” ATTITUDE… When my wife and I met Mr. Quiat my life was in turmoil. Mike sat us down and very calmly listened …When […]

    ~ Insurance Client

    unum disability claims
unum claims New York ERISA Attorney

Professional Affiliations

  • unum disability claims
  • unum claims
  • American Bar Association
  • Michael Eli QuiatReviewsout of 24 reviews
  • Martindale
  • NYC Bar
  • NJSBA
  • Bergen Bar

Areas Served :

Proudly serving all of New York and New Jersey.