For many people, there may come a point in time when you are unable to work due to a mental health or medical condition. This may be a temporary disability, or it may last for months or years. If you have disability insurance, you may be able to apply for benefits so that you maintain financial stability throughout this time.
AIG is a massive insurance company that offers both short-term disability (STD) and long-term disability (LTD) policies, typically through employer-sponsored plans. Even if you are disabled and cannot work, AIG may deny your long-term disability claim for any number of reasons, such as a paperwork error or a failure to submit sufficient medical evidence. Our law offices can help you figure out how to apply for long-term disability and can assist you with an appeal of an LTD denial.
Bross & Frankel is dedicated to helping people with disabilities get the benefits that they are entitled to under the law. We offer free initial consultations and work on a contingency fee basis for disability claims. To learn more, reach out to talk to a member of our legal team about your claim.
AIG’s Disability Insurance
American International Group, or AIG, is a multinational insurance and finance corporation. It offers a range of insurance products, from travel insurance to commercial property insurance. It also sells both long-term and short-term disability insurance.
Both types of disability insurance offer cash benefits if you are unable to work due to a disability. Short-term disability insurance generally covers disabilities that are expected to last between three and six months. Long-term disability policies cover disabilities that may last for a year or longer. Both types of insurance require a waiting period before you can apply for benefits.
Many people have short and/or long-term disability insurance through their employers. Alternatively, individuals can purchase disability insurance on their own. When disability insurance is offered through a group employer plan, it is governed by the federal Employee Retirement Income Security Act of 1974 (ERISA). Independently purchased plans are governed by state insurance laws.
AIG’s short-term disability insurance is meant to cover temporary illnesses or disabilities, such as a recovery period after surgery. Typically, you will have to wait 1 to 2 weeks before you can apply for short-term benefits. You must also meet AIG’s definition of disability under the policy terms.
AIG’s long-term disability insurance pays a percentage of a covered employee’s monthly income if they are unable to work for a longer period of time due to a disability. In many cases, an employee transitions from short-term disability to long-term disability when their disability continues beyond 3 to 6 months. As with short-term disability, you must meet the requirements – including the definition of disability – to qualify for long-term disability through AIG.
Why AIG Might Deny Your Long-Term Disability Claim
When you apply for long-term disability benefits through AIG, you will be required to submit medical evidence that shows that (1) you are disabled as defined by the insurance policy and (2) your disability has left you unable to work. If AIG finds that you are not disabled or that you are still able to work, then it will deny your disability insurance claim.
Like all insurance companies, AIG is in business to make money. Part of how they achieve this goal is by making it difficult to get your disability claim approved. AIG may deny your disability claim for any number of reasons, such as making a paperwork error. They may even hire investigators to follow you to dig up evidence that you aren’t actually disabled.
If your long-term disability policy was obtained through your insurer, then AIG will have to comply with ERISA rules regarding your claim. This means that AIG will have to provide a specific reason why they denied your claim. They will also have to disclose the standards that they used to reach their decision regarding your long-term disability benefits application.
While there are many possible reasons that AIG might deny your disability claim, we often see denials for the following reasons:
- A failure to meet the requirements to receive LTD benefits, such as being out of work for the length of the elimination period (usually 90 to 180 days)
- Insufficient evidence to support your claim, which means that you did not submit medical records or other proof to demonstrate that you are disabled
- Even if you submitted enough medical evidence, AIG’s doctors may determine that you are not disabled based on a paper review, an independent medical examination (IME), and/or a functional capacity evaluation (FCE)
- Your policy terms changed from “own occupation” coverage to “any occupation” after a period of time, which means that you have to prove that you cannot work in any job (not just your own).
No matter what the reason for the denial may be, it is important to read the paperwork that AIG sent to you carefully. It will contain important information, including deadlines for filing an appeal. An experienced New Jersey long-term disability lawyer can help you with this process, including filing a timely appeal to protect your right to disability benefits under your policy.
How to Appeal an AIG Disability Claim
Appealing a denial of LTD benefits typically starts with filing an administrative appeal. In most cases, this initial appeal must be filed within 180 days of the denial. If this appeal is denied, then AIG may require you to file a second appeal before you can take further action. If AIG issues a final denial, then you may choose to file a lawsuit against the company in federal court for ERISA (employer-sponsored) claims or in state court (if you bought your own LTD policy).
The appeals process can be incredibly complex. Not only will you have to comply with specific deadlines, but you will also need an understanding of the laws that govern these claims. AIG has its own team of lawyers, which makes it all the more important that you work with a skilled New Jersey long-term disability attorney.
If you end up filing a lawsuit against AIG, then you will probably be limited to the medical evidence and other documentation that you filed with your initial application and appeals. A lawyer can help you build a strong record that will support your claim, which may include:
- Additional medical evidence to support your contention that you are disabled
- A consultation with a vocational expert to analyze your ability to perform the duties of your job or any other occupation given your disability-related restrictions
- A report from your treating doctor about how your symptoms affect your life and your ability to work
- Statements from family, friends, and coworkers about how your medical or mental health condition affects your ability to work.
Deadlines are critical in a long-term disability appeal. If you do not file an appeal within the time period specified by your policy, then your appeal could be denied automatically – and you probably won’t be able to sue AIG in federal or state court. A New Jersey disability attorney can ensure that your claim is supported by sufficient evidence and that you meet all deadlines for filing an appeal.
How Bross & Frankel Can Help
Disability insurance is meant to provide a financial safety net for people who experience the unfortunate situation of not being able to work due to a health condition. Too often, however, insurance companies like AIG make it incredibly hard to get these benefits. If your AIG claim has been denied, our law firm is here for you.
Based in Cherry Hill, Bross & Frankel represents clients throughout New Jersey and Pennsylvania. We have substantial experience with all aspects of long-term disability claims, denials, and appeals, including filing lawsuits against insurers. To learn more or to schedule a free claim review with a New Jersey long-term disability attorney, give us a call at 856-795-8880 or fill out our online contact form.
Rich Frankel is the managing partner of Bross & Frankel. He is a member of the New Jersey and Pennsylvania bars. He has focused exclusively on disability and social security benefits since 2005.
Mr. Frankel joined what is now Bross & Frankel after having watched his father struggle with disability, fighting a lengthy illness. Mr. Frankel founded the firm’s veteran’s law practice and substantially grew the social security disability practice, focusing Bross & Frankel’s ability to fight for all of the disability benefits available to his clients.
Mr. Frankel additionally fights for clients in court, obtaining frequent victories in Social Security appeals and against insurance companies in Federal court.