OneAmerica Disability Claims | American United Life Insurance Company

• 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 several individual disability income policies through its national agreements with Illinois Mutual Life Insurance Company and Principal Life Insurance Company. AUL provides customized income protection solutions for each individual’s specific needs. These policies are typically sold to physicians, attorneys, and other professionals and executives.
• Group Voluntary Disability Insurance: Issued and underwritten by AUL, this employee-paid, payroll-deductible, voluntary disability insurance coverage offers flexible coverage design options with short and long-term benefit periods, guaranteed issue amounts, and the ability to have different coverage options under one policy.
• CorePLUS Cost-Shared 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-sharing approach to disability coverage. It offers basic and enhanced group disability coverage options, claims administration, and billing statements, and allows for joint 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 improperly denying or terminating long-term disability benefits.

American United and Disability RMS

American United Life Insurance does not administer its 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. In most cases, 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” Physicians

Disability RMS will have a claim reviewed by a supposedly “independent” doctor, even though the insurance company pays the doctor substantial sums of money. 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 opinions based solely on a review of the claimant’s medical records. As you can imagine, Disability RMS often relies upon Dr. Neuren’s opinions to terminate or deny benefits.

Another service that Disability RMS uses to retain physicians to evaluate records for ERISA disability claims and appeals is the University Disability Consortium (“UDC”) of Massachusetts. Like Dr. Neuren, many of the physicians 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’s report does not necessarily represent the doctor’s opinions.

Instead, UDC typically conducts what it calls a “quality assurance review” and may even ask a doctor to change his or her opinion to match another doctor’s opinion. When UDC doctors were caught doing this on an American United claim managed 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 it’s worth.

In short, you may have a disability claim with American United that was terminated or denied by its administrator, Disability RMS. If so, you should take a very close look at the medical reports that Disability RMS relied on to deny or terminate benefits.

Disability RMS’s Technique for Limiting Benefits in Claims with Both Mental and Physical Impairments

For claimants with co-morbid conditions, one seemingly common practice that Disability RMS uses is to emphasize mental impairments. This is important because most policies have a limited benefit period for disabilities caused by mental illness. Disability RMS will then terminate benefits at the end of this limited period (typically 12 or 24 months) because physical conditions are not disabling.

Disability RMS’s Claim Standards

Disability RMS has written claims 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 that will be used in your claim, especially if you have a claim that may have a limited benefit period (such as a claim with a mental illness limitation or if you have “concurrent” mental and physical disabilities).

Understanding Your Rights After a Disability Claim Denial by American United or Disability RMS

If you have individual insurance or are employed by the government, you may not have to go through the administrative appeal process with your insurance company to assert your rights. Consulting with a disability law professional can help you understand your specific rights and options. If you have a group disability insurance policy with American United Life Insurance Company, your plan is generally subject to the rules and deadlines of ERISA (Employee Retirement Income Security Act). Compliance with ERISA’s strict internal appeal procedures is mandatory if your disability benefits have been denied or terminated. Be aware of the tight deadlines for filing an appeal—you typically have only 180 days to do so. Some policies may offer a secondary, voluntary appeal process.

Seek Legal Representation from an American United Long-Term Disability Attorney

Attorney Nick Ortiz provides a full range of legal services to clients with long-term disability insurance policies through American United Life Insurance or OneAmerica.

These services include challenging denials or terminations of long-term disability benefits under individual or government policies, and filing ERISA appeals for denials or terminations of group long-term disability benefits. In addition, he can file lawsuits against American United Life Insurance following a final denial of benefits for individual or government policies, and file ERISA lawsuits following a final denial of group benefits denial.

Call us at (888) 321-8131 for a free case evaluation with American United disability attorney Nick Ortiz.