Statute of Limitations Provision In Disability Policy Enforceable under ERISA

What is a Statute of Limitations?

The Statute of Limitations is the amount of time allowed under the law in which a plaintiff can bring a lawsuit. ERISA does not specify a statute of limitations for filing a lawsuit within the language of the statute. As such, insurance companies often write a statute of limitations provision into the policy, the most common being a three year statute of limitations. The statute of limitation provision usually indicates that the insured has three years from the date “proof of loss is required” in order to bring suit. Until recently there was a split amongst various courts as to when the “Proof of Loss” requirement is triggered.

ERISA’s Take on the Statute of Limitations

As a general matter, the statute of limitations begins to run when the action “accrues” or when the plaintiff can file a lawsuit to obtain relief. However, under ERISA the insured must undergo and exhaust all administrative remedies (appeals) prior to filing a disability lawsuit. In the case of Heimeshoff v. Hartford Life & Accident Insurance Company, the Supreme Court determined that ERISA governed group disability policies can contain a Statute of Limitations provision that begins prior to the right to bring lawsuit. This is in contrast to the above stated general rule of a statute of limitations and serves as yet another example of how ERISA has a set of rules unlike any other area of the law.

In the Heimeshoff case, the statute of limitations enumerated in the policy was three years from the date proof of loss was required. In the underlying Court case, Hartford argued that Heimeshoff’s right to bring lawsuit was barred as she brought suit more than three years after proof of loss was required. Hartford argued that under the policy the statute of limitations began to run as of the date that Heimeshoff’s claim was initially denied by Hartford. Heimeshoff disagreed and argued that the statute of limitations to bring suit did not begin until the date of the final denial of benefits by Hartford. In deciding the case the District Court presiding over the matter and the Second Circuit Court of Appeals both sided with Hartford’s position, barring Heimeshoff’s right to bring a lawsuit of a denial of benefits under ERISA. In reviewing the lower court decisions the Supreme Court affirmed.

When “Proof of Loss” Begins

As discussed in the above case, your “deadline” with which to file a lawsuit under an ERISA disability insurance policy begins as of the date of the initial denial of benefits by the insurance company. This means that while you are going through the administrative appeal process with the insurance company your right to bring a lawsuit has already begun. Using the standard three year statute of limitations, if the administrative appeal process takes one year from the date of the initial denial of benefits this means that you would have 2 years to file your lawsuit. Many people wait to contact an attorney about filing a lawsuit under ERISA a year or two after exhausting all administrative remedies. This in turn could result in them being barred from ever bringing lawsuit.

Each disability insurance policy contains unique policy language. As such it is important to be aware of the provisions that may affect your legal rights to bring suit. If your claim has been denied and your only remaining option is to file a lawsuit under ERISA please feel free to contact our office to determine how we may be able to assist you.

Attorneys Dell and Schaefer did not represent or have any role in the Heimeshoff case.

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There are 2 comments

  • Shanetra,

    Yes, we represent insureds nationwide. Please feel free to contact us to discuss how we may be able to assist you.

    Stephen JessupSep 24, 2014  #2

  • Do you take customers from Houston, Texas?

    Shanetra EllisSep 23, 2014  #1

FAQ

Do you help Hartford claimants nationwide?

We represent Hartford clients nationwide and we encourage you to contact us for a FREE immediate phone consultation with one of our experienced disability insurance attorneys.

Can you help with a Hartford disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Hartford. We have helped thousands of disability insurance claimants nationwide with monthly disability benefits. With more than 40 years of disability insurance experience we have helped individuals in almost every occupation and we are familiar with the disability income policies offered by Hartford.

How do you help Hartford claimants?

Our lawyers help individuals that have either purchased a Hartford long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer.

Our experienced lawyers can assist with Hartford:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
  • ERISA and Non-ERISA Disability Benefit Lawsuits
  • Applying For Short or Long Term Disability Benefits
  • Daily Handling & Management of Your Disability Claim
  • Disability Insurance Lump-Sum Buyout or Settlement Negotiations

Do you work in my state?

Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.

What are your fees?

Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.

The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.

In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.

Do I have to come to your office to work with your law firm?

No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via telephone, e-mail, fax, GoToMeeting.com sessions, or Skype. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.

How can I contact you?

When you call us during normal business hours you will immediately speak with a disability attorney. We can be reached at 800-682-8331 or by email. Lawyer and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.

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