American United (OneAmerica) Disability Claims
American United Life Insurance Company (hereinafter “American United” or “AUL”) is the founding member of OneAmerica.
In 2003, American United significantly increased its disability insurance portfolio by purchasing the group life and disability business from The Union Central Life Insurance Company. American United currently offers a portfolio of disability insurance products, including the following:
- Traditional Group Long Term Disability Insurance: Issued and underwritten by AUL, this employer-paid group disability insurance is designed to help an employee continue to receive income during periods of prolonged total disability.
- Traditional Group Short Term Disability Insurance: Issued and underwritten by AUL, this employer-paid group disability insurance is designed to help employees continue to receive income during periods of total disability up to 104 weeks.
- Individual Disability Income Insurance: AUL offers a wide variety of disability income individual policies through its national agreements with Illinois Mutual Life Insurance Company and Principal Life Insurance Company. AUL offers custom-designed income-protection solutions for each individual’s specific needs. These policies are typically sold to doctors, dentists, lawyers and other business professionals and executives.
- Group Voluntary Disability Insurance: Issued and underwritten by AUL, this employee-paid, payroll deducted, voluntary disability insurance coverage offers flexible coverage design options with short and long-term benefit periods, guarantee issue amounts, the ability to have different coverage options under one policy.
- Cost-Shared CorePLUS Group Disability Insurance: Issued and underwritten by AUL, CorePLUS group disability insurance is available to employers with 50 or more eligible employees and provides a cost-shared approach to disability coverage. It offers basic and enhanced group disability coverage options, claims administration, and billing statements allowing combined payment by the employer and employee.
Unfortunately, American United does not always pay disability claims when it should. American United has been sued numerous times for wrongfully denying or terminating long-term disability benefits.
American United and Disability RMS
American United Life Insurance does not administer its own disability claims. Instead, AUL typically hires a third party administrator to evaluate each disability insurance claim, which means that American United may not be the entity making the final decision to approve or deny disability benefits. Most of the time American United subcontracts the administration of claims to Disability Reinsurance Management Services, Inc. (Disability RMS), a claims administrator based in Maine.
Disability RMS’s Use of “Independent” Medical Doctors
Disability RMS will have a claim reviewed by a doctor that is purportedly “independent” (although the doctor is paid substantial sums of money by the insurance company. One such “independent” doctor that Disability RMS routinely hires to evaluate a claimant’s medical records is Dr. Alan P. Neuren, a psychiatrist and neurologist in Maine. Dr. Neuren does not appear to see real patients in an active medical practice. Instead, Dr. Neuren also works for many other disability insurance companies, providing detailed opinion reports based solely on a review of the claimant’s medical records. As you can imagine, Disability RMS frequently relies upon Dr. Neuren’s opinions to terminate or deny benefits.
Another service Disability RMS uses to retain doctors to evaluate records for ERISA disability claims and appeals is the University Disability Consortium (“UDC”) of Massachusetts. Like Dr. Neuren, many of the doctors used by UDC no longer have active practices and no longer see actual patients. It is worth noting that the report from a UDC doctor may not necessarily contain the opinions of that doctor. Instead, UDC will typically conduct what it calls a “quality assurance review” and may even ask a doctor to change his or her opinion to match the opinion of another doctor. When UDC doctors were caught doing this on an American United claim administered by Disability RMS, UDC tried to reassure Disability RMS by stating: “we are changing our procedure such that on co-morbid reports, different wording will be used on each report.” Take that for what its worth.
In short, you may have a disability claim with American United which was terminated or denied by its administrator, Disability RMS. If so, you should look very closely at the medical reviews relied upon by Disability RMS in denying or cutting-off benefits.
Disability RMS’s Technique to Limit the Payment of Benefits in Claims with Both Mental and Physical Impairments
With respect to claimants with co-morbid conditions, one seemingly common practice that Disability RMS uses is to emphasize the mental impairments. This is important because there is usually a limited benefit period under most policies for disabilities caused by mental illnesses. Disability RMS will then terminate benefits at the end of this limited period (typically 12 or 24 months) on the grounds that physical conditions are not disabling.
Disability RMS’s Claim Standards
Disability RMS has written claim standards. These claim standards will detail the claims handling procedures directly relevant to your claim. You should request a written copy of the claim standards to be utilized in your claim, especially if you have a claim that is potentially subject to a limited period of benefits (such as a claim with a mental illness limitation or if you have “concurrent” mental and physical disabilities).
Appeal of American United or Disability RMS Denial Letter
If you have an individual policy or are a government employee, you may not have to file an administrative appeal with the insurance company to enforce your rights. You should consult with an experienced disability attorney to determine your legal rights.
If you have a group plan American United Life Insurance Company disability policy, your policy is likely governed by ERISA. ERISA does have strict appeal procedures and deadlines. ERISA requires an internal or administrative appeal if your benefits are terminated or denied. The time limit to file an appeal is very limited, usually only 180 days. Under some policies, you may have a second, voluntary appeal.
Hire an American United Long Term Disability Attorney
Disability attorney Nick A. Ortiz offers the following legal services for disability claimants that have a long-term disability insurance policy or individual disability income policy purchased from American United Life Insurance or OneAmerica:
- Appeal of an American United Life Insurance denial of individual or government long-term disability insurance benefits;
- ERISA appeal of an American United Life Insurance denial of group LTD insurance benefits;
- Appeal of an American United Life Insurance wrongful termination of individual or government long-term disability insurance benefits;
- ERISA appeal of an American United Life Insurance wrongful termination of group LTD insurance benefits;
- Lawsuit against American United Life Insurance after final denial of individual or government long-term disability insurance benefits;
- ERISA Lawsuit against American United Life Insurance after final denial of group long-term disability benefits; and
- Lump-sum buyout or settlement of an American United Life Insurance long-term disability insurance policy.
Call American United disability attorney Nick A. Ortiz at (888) 321-8131 for a free case evaluation.