Both state and federal courts can hear claims related to ERISA-governed benefits plans. However, a state court must apply federal law in deciding the claim, simply because ERISA is a federal statute. As a practical matter, then, most claims are filed in federal court.
Furthermore, although a plan participant who wishes to file a challenge to the denial of long-term disability benefits under an ERISA-governed plan can do so in state court, the insurer can, and typically will, attempt to remove the case to federal court. In order to show a basis for the removal of the claim to federal court, the insurance company must establish diversity jurisdiction, which is one basis for jurisdiction in federal court. In order to establish diversity jurisdiction, the insurance company must show that it is incorporated in a different state than the plan participant’s state of residence (which is almost always the case), and that the amount in controversy is more than $75,000. This means that either the actual amount of benefits at dispute is $75,000 or more or you have asked for an indeterminate amount of compensatory or punitive damages.
Unlike most other lawsuits, individuals who bring claims pursuant to ERISA are not entitled to a jury trial on their claims. Instead, a federal judge will be solely responsible for making a decision about these claims. The judge often decides claims based on the administrative record and the briefs submitted by the parties. In some cases, the judge will hold oral arguments on a claim in order to hear verbally from both sides. If the judge rules in the policyholder’s favor, he or she only will be able to receive the past due benefits, and perhaps interest and attorney’s fees. There is no provision in ERISA that allows for extracontractual damages, such as compensatory or punitive damages.
Bonnici Law Group provides client-focused representation throughout the ERISA claims process. We are here to consider the evidence in support of your ERISA long-term disability claim, evaluate your claim, and develop the strongest and most effective strategy for fighting any denials of coverage that you may receive. Allow us to handle your legal needs while you focus on your physical and emotional health. Contact the ERISA long-term disability attorneys of Bonnici Law Group at 619-259-5199 or email@example.com.