Appeals process
If your claim is denied in whole or in part, you may appeal this adverse benefit determination by submitting an appeal to the Appeals Administrator, care of the BP ERISA Claims and Appeals Analyst, at the following address:
BP ERISA Claims and Appeals Analyst
BP America Inc.
P.O. Box 941644
Houston, TX 77094-8644
To expedite receipt of your appeal, please do not send it via certified mail. Receipt of your appeal will be acknowledged as soon as administratively feasible, typically within 5-10 business days.
Your appeal must be submitted within 60 days of your receipt of the claim denial and should include a written statement:
- Requesting a review of the Claims Administrator's decision;
- Setting forth any new or different information upon which the appeal of the denial is based, and all facts in support thereof; and
- Including all issues or comments which you feel are relevant to the appeal.
If you do not submit a written letter appealing the claim denial within 60 days, you will be unable to file an appeal thereafter.
You may review pertinent documents to prepare your appeal at no charge to you. Upon your request, you may receive, free of charge, reasonable access to and copies of all documents, records, and other information relevant to the decision on your claim. In addition, the Appeals Administrator may request additional information from you to perfect your appeal and complete the review.
The Appeals Administrator may require you or the Company to submit, within 30 days of written notice, additional facts, documents or other evidence as the Appeals Administrator, in his sole discretion, deems necessary or advisable in making such a review. The timeframe to make a determination will be tolled (suspended) during this period. If you don't respond, a decision will be made based on the information on file. On the basis of the review, the Appeals Administrator will make an independent determination of your appeal.
You will receive a written decision on your appeal within 60 days of the plan's receipt of your appeal, unless special circumstances require an extension of time for processing. In that event, a decision will be rendered as soon as possible, but not later than 120 days after receipt of your appeal.
The decision on your appeal will be provided to you in writing. It will include the reasons for the decision, a reference to the specific plan provision(s), as applicable, and other relevant information related to the decision. Generally, if you do not receive notice of the appeal decision within 120 days after receipt of your appeal, your appeal is deemed denied.
Effect of the Appeals Administrator's decision
The decision of the Appeals Administrator on your appeal is final, conclusive, and not subject to further review. The Appeals Administrator (who is also the Plan Administrator) has complete discretionary authority to interpret and administer the plan and make factual decisions regarding eligibility, payment of benefits, and other plan-related issues.
After the claims and appeals process has concluded
If following exhaustion of the plan's claims and appeals procedures you still believe that you are entitled to a benefit under the plan, you may file a civil action under Section 502(a) of the Employee Retirement Income Security Act of 1974, as amended ("ERISA").
Time limits and venue for bringing suit
However, any civil action for benefits must be brought no later than two years following: (i) in the case of any lump sum payment, the date on which the payment was made, (ii) in the case of a periodic payment, the date of the first in the series of payments, or (iii) for all other claims, the date on which the action complained of occurred.
Any civil action for benefits under the plan must be brought in the United States District Court for the Southern District of Texas, Houston Division.
Importance of exhausting the administrative review process
If you do not file a claim, follow the claims process, or appeal on time, you will give up legal rights, including the right to file a civil action in federal court because you will not have exhausted your internal administrative appeal rights. Generally, you must exhaust your internal administrative appeal rights before you can bring a civil action in federal court.