It is a common practice in the disability insurance industry for a disability insurance company to hire a third-party company to administer claims for disability benefits. This means that a company different than the insurance company that sold the long-term disability policy will make the decision as to whether you are entitled to disability benefits.
For example, Disability Management Service, Inc. (“DMS”), states on their website that they are a full service third party administrator and consulting firm specializing in the management of individual and group disability claims. DMS further states:
“Disability benefit eligibility determinations are seldom black-and-white. Moreover, disability is rarely static in nature. People recover and return to work. Or, they remain disabled and adapt. Sometimes their conditions worsen.
DMS focuses on the importance of early and proactive involvement with every disability claim, using a team-oriented approach. DMS claim professionals often interact with treating medical providers, specialized clinical experts, medical consultants, vocational specialists, forensic accountants, investigation professionals and legal advisers to gain a comprehensive understanding of each claim. DMS has access to the expertise of a national network of Independent Medical Examination providers, Peer Review experts, and Functional Capacity Evaluation professionals who help in the assessment of impairment and its impact on the claimant’s capacity to work. Our thorough, objective process ensures that new claims receive a fair assessment of benefit eligibility and active claims are appropriately managed for the duration of the disability.”
Disability insurance companies will hire companies such as DMS, because the insurance company that sold the policy either does not have a claims handling department or they believe that it is cost effective to outsource the handling of the disability claim. We have handled numerous claims against companies such as DMS. It is important that a claimant understands that the goal of every disability claim examiner is to look at an application for disability benefits with a goal of returning the claimant to work and therefore denying benefits at some point. There are several third-party administration companies throughout the country. Recently we have represented clients in which the client had purchased a MetLife long-term disability policy, but Unum was hired to act as the third party administrator. Additionally, disability insurance companies such as Trustmark Insurance Company, are forming subsidiary companies (TrustmarkDisabilityAdvisors.com) in order to administer claims for other disability insurance companies. Attorneys Dell & Schaefer are available to answer any of your questions or concerns about the handling of your long-term disability claim.