Q: After denial, Sedgwick isn’t responding to written reqs for Copies of Claim Files OR the STD Policy, what can I do?
Fortune 100 employer, ERISA policy. Sent written requests to Sedgwick 3x, 1st was 11/22. Will not return my calls. Employer states Sedgwick provides copy of policy/Summary Plan. Sedgwick advised STD policy exhausted from previous unrelated LOA; apply for LTD via Lincoln. Without policy & files, unclear if/how to appeal. 1) Can Employer provide copy of Policy? 2) Any law pertaining to response time from administrator/Sedgwick?
A: Under ERISA, the plan administrator (usually your employer) is required to provide plan documents to you within 30 days of your request. With both your employer and the insurance company refusing to provide you anything, you may need to get an attorney involved. Feel free to contact my office and we'll talk to you for free. We handle short-term and long-term disability cases across the country and we recently helped someone with a very similar issue where the insurance company refused to provide a copy of the insurance policy. Hope this helps!
A: You may have a claim. I need to learn more.
Justia Ask a Lawyer is a forum for consumers to get answers to basic legal questions. Any information sent through Justia Ask a Lawyer is not secure and is done so on a non-confidential basis only.
The use of this website to ask questions or receive answers does not create an attorney–client relationship between you and Justia, or between you and any attorney who receives your information or responds to your questions, nor is it intended to create such a relationship. Additionally, no responses on this forum constitute legal advice, which must be tailored to the specific circumstances of each case. You should not act upon information provided in Justia Ask a Lawyer without seeking professional counsel from an attorney admitted or authorized to practice in your jurisdiction. Justia assumes no responsibility to any person who relies on information contained on or received through this site and disclaims all liability in respect to such information.
Justia cannot guarantee that the information on this website (including any legal information provided by an attorney through this service) is accurate, complete, or up-to-date. While we intend to make every attempt to keep the information on this site current, the owners of and contributors to this site make no claims, promises or guarantees about the accuracy, completeness or adequacy of the information contained in or linked to from this site.
