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Blog - ERISA and Disability Rights and Benefits - Alabama - The Martin Law Group, LLC

What happens when you miss an ERISA deadline? [Video]

Posted by David P. Martin | Oct 02, 2018 | 0 Comments

Have you ever had a close call with a case deadline? This is one of those stories. After 26 years of handling ERISA cases, even we occasionally experience new wrinkles. But, that experience enables us to deal with them. Regardless, we will always have our clients' backs as well as our referring attorneys'.

Mr. T's long-term disability claim terminated in June. The letter denying the claim gave him until December 30 to appeal. In August, he hired an attorney. He did not realize Mr. T's disability policy was governed by ERISA. Once he realized it, he referred the case to us. That was mid-November.

We scheduled a meeting with Mr. T. W requested additional documents. We had a follow-up conversation with Mr. T and felt that he would retain us, but nothing was confirmed. On December 5, we sent a written engagement agreement to Mr. T and stressed that time was of the essence. We copied the referring attorney. Our fee arrangement was different than the referring attorney's. Contracts for ERISA cases are typically a bit different than those for personal injury cases or other more common contingent fee arrangements.

Mr. T failed to send his contract back.

On December 29th, the last business day of that year, we reviewed our new and pending cases. Mr. T had not returned our contract and his deadline was looming. Were our conversations enough to constitute an engagement? If so, under what terms? Even if Mr. T hadn't formally engaged us, did we have some obligation to do something because of the referral? Had the referring attorney actually associated us?

One thing was clear – Mr. T had a contract with his prior attorney – our referring attorney. If the deadline passed without a notice of appeal, our referring attorney would likely be on the hook.

We tried to reach the referring attorney. No luck. We tried to reach the client. Again, no luck. We tried to reach them again and again. No luck. Time was ticking. Finally, it was 6:00 PM on the Friday night before New Year's Eve. Most of our office staff was long gone. We had to make a decision.

We flew into action. We drew on our past experience and the information on hand. We found the fax number for the insurance company in our database. We put together an appeal with what we had. We faxed it. Mission accomplished. Appeal lodged. Claim preserved.

We wanted to preserve the client's rights even though it was unclear whether he had actually engaged us. After all, he could dismiss his appeal if he had chosen not to pursue it or fire us if he had decided that he didn't want us to. If we didn't file the notice, and he wanted to pursue an appeal, it would have been barred. That could mean a potential malpractice claim for us and for our referring attorney.

We finally reached the client. He was very appreciative of what we had done for him. He apologized for not returning the contract sooner. Our referring attorney was appreciative too. He assumed Mr. T had signed the engagement agreement and returned it.

We were able to supplement the information we originally presented to the insurance company. Eight months later, we settled the claim.

Even after 26 years of handling ERISA cases, we occasionally experience new wrinkles. But, that experience enables us to manage them. Regardless, we will have our clients' backs. And, we will always have yours.

About the Author

David P. Martin

Senior & Managing Attorney


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