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What is the Administrative Record and why is it important?

Your ERISA claim (life, medical, or long or short term disability) has been denied, and the insurance company is referring to “the Record” or “the administrative record.” So what is that?

ERISA cases, unlike most civil cases, are not decided based on evidence generated during your lawsuit such (including the testimony of your medical providers).  Rather, and in most ERISA cases, the Court will be limited to the contents of the Record.  The Record are the documents  —  medical records, statements from doctors, test results and the like — that are contained in the insurance company’s file BEFORE the lawsuit is filed.  It is therefore very important that the Record is only complete!  While this can be a complicated process, and you may benefit from the assistance of a qualified ERISA lawyer, there are a few simple things you can do:

*  Do NOT assume the insurance company is ordering all of your important medical and other records, DO IT YOURSELF!

*  Request the insurance company’s file (you have the right to a copy), and request it in writing.  That way you can find out what the insurance company has, and more importantly, what they do not have.

*  Always send records by fax, email or mail that can be verified so you can prove what you sent.

*Include letters of support from your doctors, co-workers or family to explain just how your conditions affect your life.

 

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