AXA/Equitable Disability Insurance Claim Denied?

If your AXA/Equitable Life Insurance Company long term disability insurance claim has been denied, there are certain steps you’ll want to take without delay. The first is to carefully review the notice of denial, determine why the claim was denied, note the date the denial was issued and the deadline for an appeal.  Your claim may have been reviewed and denied by a third-party administrator – Disability Management Services.

If you purchased an AXA/Equitable long term disability insurance policy through a broker or an agent, your broker or agent will try to help you with the denial, but they may not be as effective as a disability attorney. 

If your AXA/Equitable disability insurance is through your employer, then your LTD policy is governed by federal law known as ERISA. The first step in fighting back is filing an appeal, which is a complex process. You can try to do it on your own, but having an experienced disability insurance attorney on your side will give you a far better shot at a successful appeal.

The choice of how to protect your claims is ultimately yours. After more than 24 years of experience representing both ERISA and private disability denials, Jason Newfield has seen claimants be wrongfully denied by AXA/Equitable. The denials come at various stages of the disability benefits claims process:

Denials when the claim is first filed. The reasons vary, from insufficient medical evidence to saying you’re not disabled, even when it’s clear to you and your doctor that you cannot work.

Terminations after the claim has been paid for months or even years. Once you are on claim, you cost the company money. Medical reviews, re-evaluations of your claim and even surveillance are on-going throughout the life of the claim, in an effort to manage the company’s costs.

Denied ERISA appeals. The appeal process is not as simple as adding additional medical documents or having your employer write a narrative report on the duties you cannot perform as a result of your disability. Newfield Law Group has handled many AXA/Equitable appeals and we know what the insurance company is looking for. We have a national network of medical and occupational experts who we bring on board to prepare your appeal.  Often, testing is necessary to provide further support for your claim, and finding the right resources can be important.

The AXA/Equitable Life Assurance Company  is no stranger to denying disability claims, especially when they are for disability claims with high monthly benefits – often for doctors and dentists.  

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Why is Disability Management Services Involved in Denying my AXA/Equitable Disability Claim? 

Disability Management Services is a third-party administrator for AXA/Equitable and many other disability insurance companies.  They have contractually agreed to manage the claim process.  DMS often appears in court citations, as both AXA/Equitable and DMS are sued together when disability insurance claims have been wrongfully denied or terminated.

What Lengths will AXA/Equitable Go to Deny a Disability Claim?

AXA/Equitable has a large number of lawsuits against it over the years, and disability bad faith lawsuits. This does not happen because the company is fair and generous to its policyholders. The company has a reputation for denying disability claims. It’s far more cost effective for AXA/Equitable to deny or terminate a claim than it is to pay benefits.

In one case, a lawsuit against AXA/Equitable was brought when the company sought to deny a hand surgeon his benefits because his inability to work was the result of an injury and an illness. He first suffered a degenerative joint disease in his hand, followed by a fall and a wrist fracture. Regardless of which came first, he was unable to perform the meticulous tasks required of a surgeon. AXA/Equitable denied his claim.

In another case, the owner of a small business was in a bad auto accident and it left him unable to run his business because of physical and mental disabilities. Social Security agreed that he was disabled. But AXA/Equitable, after paying his claim for a few months, terminated his claim following an IME – the so-called “Independent Medical Examination” performed by a doctor who is paid by the insurance company.

A man who worked as a broker for AXA/Equitable filed a lawsuit against AXA/Equitable and Disability Management Services. He owned four AXA/Equitable disability policies, purchased individually, and filed claims after suffering a cardiac event. After receiving benefits, he raised objections to how AXA/Equitable was counting his commissions as part of calculating his monthly income. There was also an issue concerning Cost of Living Factor for a residual benefit he was being paid. A lawsuit was filed that went from state to federal court. 

Why You Need an Experienced Disability Attorney to Fight Against AXA/Equitable

 AXA/Equitable is, like most disability insurance companies, a massive global corporation with limitless resources. Most of the AXA policies are private or individual policies, which means claimants have the right to file breach of contract claims, bad faith laws and the insurance laws of your state.  This is different from an ERISA claim, where claimants must begin with an administrative appeal. But the fight in court is just as challenging as the battle of an appeal. 

In most cases, the claim settles before going to a jury trial because the insurance company attorneys know they’ll do better with a settlement than risking the high cost of a jury trial. After all, who wouldn’t want to see a massive corporate entity pay for the stress and bad faith put upon a disabled individual?

Fighting an AXA/Equitable disability claim denial is not something to take on by yourself. If your AXA/Equitable disability claim has been denied or terminated, call Newfield Law Group to discuss your situation. The call is free, there’s no obligation and you’ll learn what you can expect from AXA/Equitable in the weeks and months ahead.

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