Assurant Employee Benefits Insurance Company, also known as Union Security Insurance Company, offers group long-term disability insurance that provides employees with income protection if they are unable to work due to an illness or injury. In most of Assurant’s long-term disability plans, the qualifying period begins on the day the insured is unable to perform at least one material duty of their job.
Unfortunately, Assurant is often more interested in getting people back to work than paying them disability benefits. This quote is from Assurant’s website:
“Our integrated WillReturn® program is a unique blending of demographic and psychographic information processing designed to get employees back to work more quickly. WillReturn® combines information from two studies commissioned exclusively for Assurant Employee Benefits, the Menninger return-to-work study and the Gallup will-to-work study, to help case mangers identify the rehabilitation services and training interventions most appropriate for each individual.”
Assurant’s goal is clearly to get employees back to work quickly. Assurant uses its own “return-to-work computer programs” to create artificial recovery periods for disabled policyholders. Assurant’s claims processors are trained to rely on computer data to determine how long a claimant “should” be out on disability based on the claimant’s medical condition.
Assurant’s analysts are further trained to look for specific medical documentation concerning specific medical conditions. The analysts are trained to deny claims if the documentation is not in the claimant’s medical record. This is no small undertaking. By some estimates, Assurant Employee Benefits has more than 1,000 employees, including medical consultants, vocational consultants, and private investigators. Again, Assurant’s website provides evidence that it looks for more reasons to deny claims than to approve them:
“Assurant Employee Benefits integrates medical and disability claims analysis to target cases that are under medical case management and identifies cases appropriate for early intervention with disability management practices. Our in-house special investigations unit assists in examining potentially fraudulent claims. Having this unit in house assures that investigators understand the LTD contract, protect the confidentiality of the claimant and their relationship with the policyholder, and assures that surveillances are complete.”
Assurant Long-Term Disability Plan Options
Assurant gives employers options to choose from to customize their LTD plans.
- A key feature is selecting the most appropriate definition of disability to meet the needs of different employee groups. Assurant offers three definitions of disability, including a unique “dual” definition that triggers benefit payments based on a loss of duties or loss of earnings. A loss of both is not required.
- Assurant’s Critical Illness benefit provides a lump sum payment, in addition to disability income protection, to claimants suffering from certain critical illnesses such as cancer, heart attack, stroke, kidney failure, or trauma resulting in paraplegia or quadriplegia.
- Assurant’s Activities of Daily Living (ADL) benefit pays an additional benefit that increases the policy’s overall benefit rate to either 80% or 100% of pre-disability income for claimants suffering from severe disability. This benefit is designed to help these severely disabled claimants pay for the additional expenses they often incur.
- If an insured person dies while receiving long-term disability benefits, the Survivor Benefit provides income to the member’s survivors while the estate is being settled.
- Assurant’s Employee Assistance Program (EAP) gives employees access to confidential short-term counseling and referral services designed to help them deal with family, legal or financial concerns.
- Assurant’s Business Income Benefit provides an additional benefit to an employee who is the primary source of income for the business becomes disabled.
Appeal an Assurant Long-Term Disability Denial
If you have a group disability policy with Assurant, your policy is likely governed by ERISA. ERISA has strict appeal procedures and deadlines. ERISA requires an internal or administrative appeal if your benefits are terminated or denied. The time limit for filing an appeal is usually only 180 days. Some policies allow you to file a second, optional appeal. You should consult with an experienced disability attorney to determine your legal rights.
Get a Free Case Review with an Assurant Long-Term Disability Attorney
Disability attorney Nick A. Ortiz offers the following legal services to disability claimants who have purchased long-term disability insurance from Assurant:
- ERISA appeal of an Assurant denial of group LTD insurance benefits;
- ERISA appeal of an Assurant wrongful termination of group LTD insurance benefits; and
- ERISA lawsuit against Assurant after final denial of group long-term disability benefits.
Contact us today to speak with an experienced Assurant disability lawyer. Call the Ortiz Law Firm today at (888) 321-8131 for a free case evaluation.