In 1974, the Employee Retirement Income Security Act was passed and made law. This act set minimum standards to be met by pension and health plans that were established by the individual, as well as protection to ensure coverage through these plans. In other words, a person who has or develops a long term disability cannot be denied their benefits due to having that disability. If they are denied benefits, the employer or employer’s insurance provider could be held liable and sued.
Some medical conditions, such as chronic fatigue, chronic pain and lupus, are hard to see through tests and x-rays. Insurance providers are often very reluctant to cover such conditions, and might initially deny benefits to a client. However, the Employee Retirement Income Security Act makes this illegal, and clients are entitled to receive the benefits that they rightfully deserve.
There have been several amendments added to the Employee Retirement Income Security Act since it was drafted in 1974. These amendments include provisions such as the right of an employee and their family to continue to have coverage over an extended period after losing the actual job or other events. Through this legislation, people are better protected and the risks of being without health and pension benefits are reduced.
Unfortunately, wrongful denials are all too common and can lead to clients being overwhelmed in medical debt that should have been covered by their health care provider. If you or someone whom you know has been denied coverage for a condition in Wisconsin, speaking to an experienced attorney could be very beneficial.