Never ignore a 180 day ERISA Appeal deadline or it is likely you will never have an opportunity to present your disability insurance claim denial in court.
The case of Reindl v. Hartford Life and Accident Insurance Company is one example of what can occur if you fail to file a timely ERISA appeal. The Plaintiff, Ms. Reindl participated in an employee welfare benefit plan administered by Hartford Insurance Company during her employment with RKM Enterprises. She stopped working in 2005 and applied for disability benefits which were approved. In 2008, Hartford sent her a letter terminating her long term disability benefits claiming that she was able to work and gave her 180 days to file an ERISA appeal. Ms. Reindl hired an attorney (not Dell & Schaefer) to file the appeal for her. In December of 2008, the attorney sent a letter to Hartford requesting her claim file and medical records, but failed to file the appeal prior to the 180 day deadline. Hartford did not accept the appeal stating that it was received after the 180 days had expired. Plaintiff’s attorney claimed that the letter he sent in December of 2008 requesting records should be considered the appeal. Hartford disagreed and the court agreed with Hartford.
A MERE REQUEST FOR RECORDS IS NOT CONSIDERED AN ERISA APPEAL
Ms. Reindl filed a lawsuit against Hartford challenging termination of their long-term disability benefits. The District Court Judge in Missouri granted Hartford’s Motion for Summary Judgment on the basis that Plaintiff’s attorney failed to file a timely appeal and the letter sent by Plaintiff’s attorney requesting records was not considered an appeal. Plaintiff appealed the decision to the 8th Circuit Court of Appeals. The Court upheld the lower court’s decision holding that a timely administrative appeal is a prerequisite to filing an action in federal court challenging the denial of benefits under a plan governed by ERISA. The Court concluded that Hartford’s determination regarding the December 2008 letter was reasonable, as a request for records is not an appeal. Therefore, the decision of the lower court was affirmed and Plaintiff cause of action was dismissed with prejudice.
How can you prevent this very situation from happening to you? The best solution is to make sure to contact an experienced ERISA attorney as soon as you receive your denial letter. This way you can ensure that your attorney has ample time to investigate and build up your claim in order to put together an elaborate appeal in a timely manner. The failure to exhaust your administrative remedies will prevent you from being able to bring suit in a court of law. Once this mistake is made, it is almost impossible to correct. Contact Attorneys Dell & Schaefer for a free consultation and we will let you know immediately if we can assist you with your claim.