Claims Procedures - Voluntary Level of Appeal

[Guest DMK]

Under the new claims regs, a plan can have a voluntary level of appeal if no fees or costs are imposed on the claimant as part of the voluntary level of appeal. Does that mean that the plan would be responsible for the claimant's legal fees if the claimant hired an attorney for a mediation or arbitration? I want to say no, but would love to hear what others think.

[Kirk Maldonado]

My guess is that the test is that no fees, etc. are imposed by the plan (on the participant).

[GBurns]

A claimant's legal fees are not something that any plan can or could ever impose. These fees are costs incurred at the sole discretion of the claimant and are charged by the claimant's selected attorney and is therefore not a plan issue.