Today we are discussing the important reasons why you need plan documents, and who can provide them for you.
Let me take this opportunity to note that if you do not have a copy of the Plan Documents, you are entitled to receive a copy, free of charge, from the “Plan Administrator” which is usually the Employer, or some committee or division thereof. You need only send a letter, preferably by “Certified Mail, Return Receipt Requested,” and they have 30 days within which to respond. If they do not respond, there are penalties which may apply. I would suggest you not rely on oral requests. I would also suggest that this should be done at the commencement of your claim so you can see the direction your claim might be headed. At Herbert M. Hill, P.A., one of the first letters which go out is the request to the Plan Administrator for those documents. Those documents include not only the “Plan Documents” but also any “Summary Plan Description.” The import of this is that there have been cases in which these documents differed from the ones being used by the Insurance Company to render its benefits determination. If there is a difference, there is very specific case law which determines which documents govern the claim.
Please keep in mind that the foregoing is not intended as legal advice applicable to any individual person’s unique legal situation. Its sole purpose is to give a general idea of the existing status of the law as it applies to the point of law addressed above. You cannot rely on the foregoing as legal advice. You cannot make legal decisions based on its contents. If you have questions arising out of this point of law, you should contact an attorney who routinely handles claims involving policies of disability insurance. The law offices of Herbert M. Hill, P.A. handles such cases and would welcome the opportunity to discuss your case with you, at no charge. You can contact me at 407-839-0005 or at hmh@herbertmhill.com.
If you would like, after discussing your case, we can set a conference. That conference would be free of charge and you would be under no obligation to hire me nor would you feel any pressure from me to do so.
Herbert M. Hill, P.A. is a law firm located in Orlando, Florida with a practice extending throughout the state of Florida and the southeastern part of the United States. Areas of practice include disability and employee benefit claims of all sorts. The firm handles any claims arising under the Employee Retirement Income Security Act (known and referred to as “ERISA”) for disability benefits, medical benefits, retirement benefits of any sort, including pension, 401k, termination agreements or the like as well as claims arising under private disability policies.
