The Shark in the Office: The Biting Reality of Company-Sponsored Insurance Plans

July 17, 2007

People see the acronym ERISA everywhere. It is on their insurance documents, insurance cards and even forms they sign in the doctor's office, but so many do not understand what it means, says Frank N. Darras, the nation's leading disability and long-term care lawyer.

The Employee Retirement Income Security Act (ERISA) was passed in 1974 and was supposed to help employees. Now, when employees are wrongfully denied their benefits, ERISA eliminates their right to a trial by jury and to punishment damages for emotional distress.

"ERISA has left a sea of denied employees without a remedy and whether you are the CEO or the receptionist, you have no leverage," says Darras.

If your insurance card says, ERISA: Y, beware. Darras explains: — Long-term disability under a company-sponsored plan usually covers the insured for only 24 months in his own occupation. — After that, the definition of disability shifts to any occupation for which the person is trained, educated, or suited. — To collect payment, you may have to be Social Security disabled. — Social Security disabled means your unable to do any work by which your trained, educated or suited but age is a significant factor. — If you are not Social Security disabled, your insurance company will say you can monitor video surveillance. The Sharks Are Circling
Medical employee insurance claims are not the only area swept under in the Sea of ERISA, it's your life and disability insurance as well.
If you are a disabled employee and your group insurance carrier denies your legitimate claim and your home is foreclosed on, your equity is extinguished. Your credit is destroyed. Those damages are not collectible under ERISA.
Life insurance claims that fall under ERISA are treated the same way as group medical and disability.
To survive, Darras suggests: — If you can afford the premiums, buy your own disability, medical and life insurance. — If you can't, make sure you hire a terrific lawyer to help you navigate these shark-infested waters.