Are there any penalties if a disability insurance company violates ERISA?
ERISA is probably one of the most complicated Federal laws out there. It’s comparable to the IRS Tax code that a lot of people don’t understand. There are very few lawyers throughout the country that actually focus their practice on ERISA disability claims.
There are penalties within the ERISA code against plan administrators or insurance companies if they don’t provide documents within a certain number of days, if they don’t have the appropriate medical provider’s review claims. So there are some penalties but they are minor monitory penalties. For example, one of the penalties is a $100 a day if they don’t provide you with a full copy of your claim file within 30 days.
Disability insurance companies love ERISA governed claims because there are no claims for bad faith or punitive damages. Furthermore, there is no guarantee that attorney fees will be paid if the case is won.