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ERISA Litigation

The healthcare industry is complex, and patients are faced with unique challenges and limitations that hinder their ability to receive healthcare coverage through their employer provided health benefit plans. If you are struggling with a healthcare need and require coverage, navigating health benefit disputes can feel like an insurmountable financial and emotional burden. When these disputes require the need for litigation, seeking assistance from an experienced attorney can make all the difference in the outcome of your case.

Health benefit litigation for patients covered under ERISA plans is the focus of Green Health Law, and our team of experienced attorneys leverage their extensive knowledge of the evolving healthcare industry with our clients’ unique needs to devise practical and effective litigation strategies. We explore creative approaches for resolving disputes as quickly and efficiently as possible and when trial is necessary, we advocate tirelessly for our clients’ interests in the courtroom. To learn more about what sets us apart, consider connecting with our team today.

Our Comprehensive ERISA Healthcare Litigation Services

From nationwide class action lawsuits to medical necessity denials, our attorneys are actively involved in a range of complex ERISA health benefit litigation matters. We bring to the table an in-depth understanding of healthcare issues and provide effective legal counsel to individuals facing difficult issues related to their healthcare. Our seasoned trial attorneys have successfully resolved countless disputes for our clients regarding ERISA health benefits, including: 

  • Reimbursement and non-payment claims 
  • Medical necessity denials
  • Violations of mental health parity laws 
  • Improper payment practices
  • Policy termination and unjust coverage cancellation 
  • Administrative appeals

The scope of our practice is national, meaning we represent clients across the country and have litigated ERISA health cases to trial in various states including California, Washington, Nevada, Arizona, Montana, Kansas, Texas, Illinois, Georgia, North Carolina, New Jersey, New York, and Connecticut.

Our attorneys have experience navigating mediation and different alternative dispute resolutions processes, and we strive to resolve all disputes outside of court whenever possible in our client’s interests. In some situations, litigation is necessary to fully obtain necessary health benefits and hold claims administrators and health plans accountable. When a case reaches litigation, we represent our clients with passion, professionalism, and knowledge to ensure that their interests are prioritized at every step of the process. 

What Is the ERISA Litigation Process?

Litigation is a formal legal procedure within the court system and ERISA requires a streamlined approach to litigation which is followed by federal courts across the country. All ERISA cases are litigated in federal court, not state court. While there are specific steps that must be followed and rules that must be adhered to during all stages of federal litigation, the process may vary depending on the district court handling the specific case. The general process involved in ERISA litigation includes: 

  1. Complaint. Lawsuits are initiated by the plaintiff stating the legal grounds for their action. In this complaint, the person or people bringing the lawsuit must state all of their claims against the defendant. For example, if you are suing your health plan and possibly claims administrator for denying benefits or cancelling coverage, this must be explained in the complaint. 
  2. Defendant Responds. After being served with the complaint, the defendant will respond with a formal answer or other responsive pleading. 
  3. Initial Conference. At this stage, the Court holds an initial conference with attorneys for both parties who prepare a joint statement or letter to the Court with a summary of the case and pretrial dates. 
  4. Discovery. In ERISA cases, discovery is limited except for specific circumstances. The parties will exchange information and documents regarding their claims and defenses. ERISA streamlines the litigation process and courts generally disallow evidence (like a plaintiff’s deposition) that was not developed during the appeal process. 
  5. Mediation or Settlement Conference. Most federal judges require the parties to engage in a settlement process, such as a private mediation or settlement conference with a judge, to attempt to informally settle the case.  
  6. Trial briefs. An ERISA matter is generally decided based on the briefs submitted by the attorneys for the parties explaining the facts, legal issues, and case law which supports their respective arguments.
  7. Trial. Federal judges may hold an oral argument in ERISA cases which allows the attorneys to orally present their arguments and answer questions from the judge. 
  8. Judgment. A decision is issued by the judge.  

How Can an Experienced Attorney at Green Health Law Help?

When you work with our team, you can expect to be treated with respect and have your case managed with the highest degree of integrity and professionalism. We will guide you through every stage of the litigation process, representing you to draft the Complaint, initiate the lawsuit, communicate with defense counsel, appear in court, and prepare your case for success. Our attorneys will represent you in trial, employing legal strategies that are backed by over 20 years of experience. 

Our client-centered approach and resolute commitment to the rights of patients and plan participants is what sets us apart from other law firms. We reject the one-size-fits-all approach to litigation, instead opting to provide tailored legal counsel that prioritizes your needs, long-term goals, and financial security. Having an experienced Green Health Law attorney in your corner to protect your interests in court will not only improve your chances of reaching a favorable resolution in court, but also ensure that you obtain the benefits you deserve. 

Speak With Our Team Today

ERISA litigation is a narrow and complex legal process and requires an in-depth knowledge of relevant legal standards, industry trends, and prior court decisions. At Green Health Law, we passionately uphold the rights of patients and plan participants and steadfastly advocate for our clients’ interests both in and out of court. 

If you are struggling with a legal dispute related to your health coverage or benefits plan, our attorneys can provide high-quality and effective legal representation to resolve your issue in trial. To discuss your case in greater detail, consider contacting our office to schedule a consultation today.