Up to now, our blog series has focused on best practices for implementing a plan’s claims and appeals procedure. We shift gears this week to see how following these best practices pays dividends if a participant’s (or beneficiary’s) claim is denied and the participant decides to pursue the claim for benefits in court (or, if
Benefit Claims
Best Practices in Administering Benefit Claims #7 – Understanding Attorney-Client Privilege in the Benefits Claims Process
When a plan administrator is attending to a benefit claim and thinks it is time to call in an attorney, are those discussions privileged and protected from disclosure to claimants? In this week’s blog, we take a look at some of those communications between attorneys and plan administrators and examine whether or not they are…
Best Practices in Administering Benefit Claims #6 – Distinguishing an Inquiry from a Claim
It’s Week #6, and we have turned the corner in our Top 10 Best Practices in Administering Benefit Claims. In case you missed any (or all) of the first five best practices, links to each of them appear below. This week we discuss how to distinguish an inquiry from a claim for benefits.
The claims…
Best Practices in Administering Benefit Claims #5 – Establishing (and Following) a Good Claims Process
This week we discuss the importance of establishing good claims procedures and the benefits of following those procedures.
A plan’s claims procedures should be spelled out clearly in both the plan document and the summary plan description (where the two documents are not one in the same). In addition to setting all of the applicable…