If you have a long term disability insurance policy through AIG, often known as American General, you may be wondering what to expect when you submit a claim for disability benefits. Although AIG isn’t one of the biggest players in the long term disability insurance world, it issues enough policies that the team at Dell & Schaefer has plenty of experience when it comes to handling AIG disability claims. Read on to learn what we’ve discovered about AIG’s processes and what they’re looking for when they evaluate a disability insurance claim.
AIG American General Life Insurance Company Disability Benefit Claim Tips and Overview
Most AIG American General long term disability policies are offered through an employer (known as an ERISA policy), not offered on the open market. This means you can expect your claim to proceed in federal court, rather than state court. Because they’re litigated under federal law, ERISA claims are governed by different standards and rules than state law breach-of-contract claims. An ERISA claim is generally handled the same way no matter where you are in the country, while the outcome of a state law contract claim will vary widely based on where it is filed.
The Five Most Important Things To Know When Filing an AIG Disability Benefit Claim
The first question to ask about your AIG long term disability policy is how long you’ve been covered. If you’ve only had this policy for a year or less, you may be at risk of running into a pre-existing condition clause – that is, if you visited a doctor for a certain condition within the three to six months before you began coverage under the policy, it may be excluded as a pre-existing condition.
From a more substantive standpoint, it’s important to know how your policy defines “disability.” Is a claimant disabled whenever they can no longer perform their own occupation (an “own occupation” disability clause), or is a claimant disabled only when they can’t perform any occupation (the “any occupation” disability clause)?
Next, you’ll want to know what’s contained (and absent) from your medical records. Has your condition been properly documented, and is it clear from your medical records that this condition is keeping you from working?
Finally, you’ll want to identify your disability policy’s elimination period. The elimination period is the length of time between the onset of your disability and when you can begin receiving disability benefits.
Steps that Must Be Taken if Your AIG Disability Benefits Claim is Denied and Appeal Tips
The ERISA mechanisms really begin to kick in when a claimant needs to appeal their AIG disability claim denial. ERISA requires a claimant to file an administrative appeal before they can file a lawsuit, and this appeal must be filed within 180 days after the disability claim is denied.
The ERISA appeal presents the most important opportunity for a claimant to create a complete record. If the appeal is denied and the claimant chooses to sue, their evidence is limited to the evidence they presented in the appeal record. This means the appeal is the time to gather all necessary information to support the benefit claim, including additional testing or records from a medical specialist.
Creating a Custom Attending Physician Statement is a Great Tool to Help Win an AIG Appeal
When reviewing your AIG disability claim, the reviewing representatives want to see a few key things. Unfortunately, these elements are hard to include in the limited space most claim forms provide. By creating a custom attending physician statement that includes a detailed explanation of how your disability prevents you from working, you’ll be well equipped to show your entitlement to long term disability benefits.
Whether you’re just preparing to file your claim for AIG disability benefits or are hoping to prevail on appeal, Dell & Schaefer can help. Our experienced team has tackled hundreds of AIG claims and can help you navigate the ins and outs of your policy. Get in touch to set up your FREE consultation today.