Claims for Benefits

A plan administrator may not wrongfully deny a claim for benefits under a plan governed by ERISA. Once a plan participant files a claim, the plan has ninety days to inform the participant whether the claim is accepted or denied. If the claim is denied, the plan must tell the participant how to submit the denial for a full and fair review, and must give the participant sixty days to do so. Once the participant submits a request for review, the plan must review the denial and make a decision within 120 days. If the participant still believes that the denial was wrong, may file suit against the plan under ERISA.