Anthem is a huge health insurance company. You may recognize the name from their Blue Cross and Blue Shield Association, but they also sell short and long term disability benefits under the name Anthem Life, or Anthem Life Insurance Companies.
Most Anthem LTD Policies Are Covered By ERISA and Contain Restrictive Language
Most Anthem LTD policies are sold as group plans. This means an employer will provide this as a benefit to its employees. Almost all employee benefit plans are covered by ERISA, a bunch of federal laws and regulations.
Generally, most Anthem disability policies will contain a 24 month “own occupation” definition of disability, and then convert to “any occupation” thereafter. Own occupation disability is easier to prove. You only need to show you cannot perform the duties required of your current/previous occupation. Any occupation is harder to show, as you need to prove you can’t perform the duties of any occupation.
For an in-depth discussion regarding the difference between these two, visit our Should Ask Questions page.
There are also usually a 24 month mental nervous limitation. An example of that limitation may read:
To 24 months in your lifetime if your disability is caused or contributed to by mental disorders, substance abuse or other limited conditions, including but not limited to chronic fatigue conditions, allergy or sensitivity to chemicals or the environment, chronic pain conditions, carpal tunnel or repetitive motion syndrome, temporomandibular joint disorder or craniomandibular joint disorder
Anthem Life Usually Requires Objective Evidence For Long Term Disability Claims
The requirement of “objective evidence” usually gives the insurer wiggle room to deny your claim. They simply need to claim there isn’t enough objective evidence, and they get to deny your application for benefits.
The language of your policy controls, but in general they will define what objective evidence means. An example of policy language may be similar to:
Objective medical findings which support your Disability. Objective medical findings include but are not limited to tests, procedures, or clinical examinations standardly accepted in the practice of medicine, for your disabling conditions.”
If your long term disability claim with Anthem Life was denied or terminated, The Disability Legal Center can assist you. We can review your denial/termination letter, prepare your appeal, and file a lawsuit in Federal Court if necessary to help you obtain your rightful benefits.
We welcome you to contact us for a free lawyer consultation. There is no obligation.