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Re: Causes of action under ERISA?
Posted by Rob on 10/26/07
The basis of their Motion to Dismiss is probably that you
did not exhaust your administrative remedies prior to filing
suit.
How long has it been since he had the surgery and benefits
were denied. You really need to look at the Summary Plan
Description and Schedule of Benefits and other plan
documents.
Given the date on this request, you may already be in
trouble as far as involuntary dismissal is concerned.
On 8/19/07, mark wrote:
> I represent a client who was pre-approved by his health
> insurance carrier for a much-needed back surgery.
> Alhtough the surgery was pre-approved, the carrier
> subsequently denied his claim for benefits on the basis
> that the surgery was experimental. We filed suit in state
> court alleging breach of contract, fraud, bad-faith, and
> seeking a declaratory judgment. the carrier then removed
> the matter to federal distirct court on the basis that the
> health insurance was an employee benefit plan under
> ERISA. Simultaneously, the defendant filed a motion to
> dismiss onm the absis that all of plaintiff's claims are
> preempted and that he has no remedy under federal law.
>
> I am filing a motion to remand which I expect to be
> denied. In that event, I want to be ready to file an
> amended complaint which sets forth colorable claims under
> ERISA. I've never dealth with ERISa before and am getting
> a headache. How do I couch my claims in sucha manner to
> set forth claims under ERISA?
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