Author and Insurance Expert, Brett Goldstein Explains What Employees Really Need To Know
PLAINVIEW, NY, November 1, 2011 – -More often than you would think, health insurance companies refuse to pay medical expenses. When this happens, most people think that they can sue the insurance company just like in the movies, but not so fast. When you have health insurance provided by your employer, you give up your seventh amendment right to a trial by jury if you are wrongfully denied your coverage.
Any employee, whether the least paid or highest paid, loses his ability to sue insurance companies for losing a home, bankruptcy, poor credit ratings and emotional distress. ” “That”s right, insurance companies are not held to account for their bad faith actions of wrongful denial. If you are lucky enough to get a court date to sue your insurance company, the only thing you can sue for is the cost of the medical treatment the insurance company refused to pay, and that is it,” explains Brett Goldstein, author of “The Retirement Crisis”.
Employer health insurance is covered by the Employee Retirement income Security Act of 1974 (ERISA). Initially passed by Congress as a simple and comprehensive way to reduce employee benefits litigation and protect employees, it has now become a loophole allowing insurance companies to make huge profits by denying claims without having to pay for expensive lawsuits.
In a poor economy, rising prices and unemployment are not all that is chiseling away at retirement funds. Wrongful denial and ERISA sets employees up to deplete their retirement savings to cover costs of much needed medical care that some insurance companies refuse to pay, says Goldstein.
Goldstein makes a complicated law simple to understand with this example:
If your employer provided health insurance didn”t pay for a $50,000 medical treatment and it cost you a chunk of your life savings, you can”t sue. This is reality of ERISA and it is a nightmare. The only thing you can sue for is the $50,000 medical treatment.
Employer provided health insurance is not the only type of insurance under ERISA, it also includes employer provided life insurance and disability insurance. When Goldstein interviewed Frank N. Darras, the nation”s top insurance lawyer, Darras made it clear that people who are concerned about losing their retirement savings should buy their own health, life and disability insurance instead of getting it through their job. ” “That way if an insurance company refuses to pay for something that should be covered, you can hire a good lawyer to sue them and also recover costs that sometimes equal your life savings,” says Darras.