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ERISA: Right Of Appeal

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  • ERISA requires that you appeal within 60 days of a denial of a claim. 
  • The insurance company then has 60 days to review the claim a second time (with an option for an additional 60 days if they need it). 
  • The details on appealing, including deadlines, should be in the denial letter.
  • The appeal must also be handled by someone in a higher position than the person who originally denied the claim. 
  • Although only one appeal is required by ERISA, many insurance companies will consider a second appeal. A second appeal should only be used when there is substantially important new material or when you want to enter information into the claim file before a suit is filed.





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