For Subscribers

Request Denied?

Protect employees from a health insurance loophole.

By Jacquelyn Lynn

Opinions expressed by Entrepreneur contributors are their own.

Employees who participate in group health insurance could beleft with a hefty tab if the insurer denies a claim. A little-knownprovision in the Employee Retirement Income Security Act of 1974,or ERISA, holds that, with a few exceptions, people who get healthcoverage through a group policy at work cannot sue their insurancecompanies under state law, and their options under federal law arelimited, says Arnold Levinson, an attorney and partner at Pillsbury &Levinson LLP in San Francisco.

"Under federal law, the insurance company gets to decidewhether your claim is paid or not, and they don't even have tobe right," Levinson says. "All they have to do is showthat they were not arbitrary and capricious. While you might beable to sue in federal court, you can't win unless you provethe insurance company [was] arbitrary and capricious."

Continue reading this article — and all of our other premium content with Entrepreneur+

For just $5, you can get unlimited access to all Entrepreneur’s premium content. You’ll find:

  • Digestible insight on how to be a better entrepreneur and leader
  • Lessons for starting and growing a business from our expert network of CEOs and founders
  • Meaningful content to help you make sharper decisions
  • Business and life hacks to help you stay ahead of the curve

Related Topics

Editor's Pick

Everyone Wants to Get Close to Their Favorite Artist. Here's the Technology Making It a Reality — But Better.
The Highest-Paid, Highest-Profile People in Every Field Know This Communication Strategy
After Early Rejection From Publishers, This Author Self-Published Her Book and Sold More Than 500,000 Copies. Here's How She Did It.
Having Trouble Speaking Up in Meetings? Try This Strategy.
He Names Brands for Amazon, Meta and Forever 21, and Says This Is the Big Blank Space in the Naming Game
Business News

American Airlines Sued After Teen Dies of Heart Attack Onboard Flight to Miami

Kevin Greenridge was traveling from Honduras to Miami on June 4, 2022, on AA Flight 614 when he went into cardiac arrest and became unconscious mid-flight.

Leadership

How to Detect a Liar in Seconds Using Nonverbal Communication

There are many ways to understand if someone is not honest with you. The following signs do not even require words and are all nonverbal queues.

Business News

Singer Jewel Says Her Mom Allegedly Stole $100 Million From Her: 'I Woke Up and Realized She Embezzled All of My Money.'

The singer opened up about her estrangement from her mom and the alleged theft on the 'Verywell Mind Podcast.'

Business News

TikTok CEO Testifies in House Hearing: We Are Building 'Firewall' Around U.S. Data

The CEO of TikTok, Singapore-born Shou Chew, testified before Congress for the first time on Wednesday. He promised to safeguard U.S. data.

Green Entrepreneur

A Massive Hole In the Sun May Cause Dazzling Light Show Here On Earth

NASA says the coronal hole could blast the Earth with solar winds as early as Friday. What does this mean?