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Stake a Claim: Applying Claims Procedures in ERISA Plans

June 06, 2023 (3 min read)

A recent case in the Eighth Circuit makes clear that plan documents, and what they say, are important. We know this, but sometimes, especially in welfare benefit plans, the particulars aren’t always spelled out.  ERISA plans often require participants to exhaust internal claim procedures before they can take the plan, or its fiduciaries, to court. In this Eighth Circuit case, the claim denial letter to a life insurance beneficiary required exhaustion, but the plan document didn’t. ERISA requires that the terms of an employee benefit plan be committed to written plan documents so that plan participants, by reviewing those documents, can learn their rights and obligations under the plan. So said the court, too.

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Related Content

  • ERISA Claims Review Procedures Process Map 
    Reference this process map providing an overview of the key stages in the life cycle of a typical claim for benefits made by a participant or beneficiary in an ERISA employee benefit plan.
  • ERISA Claims and Litigation Resource Kit
    Learn more about claims and litigation in the benefits arena. This resource kit includes documents regarding ERISA litigation, claims procedures, self-correction and agency-correction programs, and agency (DOL and IRS) plan investigations.

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