Should I appeal a denied insurance claim in the US?
Appeal when the expected value — the benefit at stake times your odds of success, minus fees and costs — is positive. For ERISA plans you must exhaust the internal appeal before suing, and you should build the administrative record fully because courts usually will not consider new evidence later.
What is the difference between ERISA and non-ERISA claim appeals?
ERISA (employer group plan) appeals require you to exhaust the plan's internal appeal, and on judicial review the court often applies a deferential standard, lowering your odds. Non-ERISA claims — individual policies — are governed by state law, allow de novo review, and permit bad-faith and punitive damages, raising the potential recovery.
How long do I have to sue over a denied claim in the US?
Deadlines vary by state and by the policy's own limitation clause, which ERISA courts generally enforce. Some policies limit suits to as little as one to three years after proof of loss. Because ERISA also imposes strict appeal deadlines, you should act immediately and consult counsel.
Can I recover interest and attorney's fees on a successful appeal?
Often yes. Under ERISA, a court has discretion to award attorney's fees and prejudgment interest to a prevailing claimant. Under state law, many states allow interest, fees, and bad-faith damages when an insurer wrongfully denies a first-party claim.