Ameritas Disability Insurance Claim Denial Attorney
When an illness or injury prevents you from working, disability insurance benefits can become your primary source of financial support. If Ameritas Life Insurance Corp. denies your claim, delays payment, or terminates benefits you were already receiving, the financial consequences can be immediate.
At Pillsbury & Coleman, LLP, our California disability insurance attorneys represent policyholders in disputes involving denied and terminated disability benefits. We investigate whether an insurer has properly interpreted the policy, fairly evaluated medical evidence, and fulfilled its contractual obligations.
If your Ameritas disability insurance claim has been denied, our firm can review the circumstances and help determine your legal options.
Understanding Ameritas Disability Income Insurance
Ameritas offers individual disability income insurance designed to replace a portion of a policyholder’s earnings when illness or injury prevents them from working. Its disability insurance offerings include DInamic Cornerstone Income Protection and other products designed to provide income protection under different circumstances.
Unlike long-term care insurance, disability income coverage focuses on the insured’s ability to work and earn income.
Depending on the policy, disability benefits may be affected by:
- The definition of total or partial disability
- Whether the insured can perform their regular occupational duties
- The elimination period before benefits become payable
- Monthly benefit amounts and maximum benefit periods
- Residual or partial disability provisions
- Policy exclusions, limitations, and applicable riders
The precise policy language determines eligibility. A disability determination should account for the insured’s actual occupational responsibilities rather than relying solely on a medical diagnosis.
Ameritas Claims-Handling Tactics
Although disability claims may be denied when an insurer concludes that the available evidence does not satisfy the policy’s definition of disability, we have encountered instances where Ameritas has claimed it cannot make a claim determination for an extended period of time. Insurers must conduct a thorough investigation in order to comply with the covenant of good faith and fair dealing. But this does not operate to allow insurers to unreasonably delay claim payment or to ask for unnecessary or burdensome information. If you feel that Ameritas is delaying payment of benefits or insisting upon receipt of irrelevant information, contact us.
Additionally, disputes can arise when an insurer relies on medical record reviews, vocational assessments, or interpretations of occupational duties that conflict with the policyholder’s evidence.
Common issues in disputed disability claims include:
- Insufficient medical evidence: The insurer maintains that the submitted records do not establish disabling functional limitations.
- Occupational disagreements: The insurer concludes that the claimant can continue performing their occupation despite documented restrictions.
- Pre-existing condition provisions: The insurer applies a policy exclusion or limitation based on prior medical history.
- Disputed disability duration: The insurer determines that the condition no longer satisfies the policy’s requirements.
- Income calculations: Disagreements arise concerning earnings, residual disability benefits, or income loss.
- Failure to provide requested documentation: The insurer concludes that additional medical or financial information is necessary.
A denial should be evaluated against the actual insurance contract and the evidence available when the decision was made.
When Ameritas Terminates Previously Approved Disability Benefits
An initial approval does not necessarily guarantee that disability payments will continue without further review. An insurer may periodically request updated medical records, attending physician statements, income information, or evidence of ongoing functional limitations. A termination may also occur when the insurer concludes that the claimant’s condition has improved or that the claimant can return to work.
For policyholders with chronic illnesses, neurological conditions, musculoskeletal injuries, or other long-lasting impairments, these determinations can become disputed. A claimant may remain unable to perform the substantial duties of their occupation even when certain medical findings improve.
If Ameritas terminates benefits, obtaining the claim file and identifying the evidence supporting its decision can be important steps in evaluating whether the termination was justified.
Own-Occupation Disability Coverage and Professional Claims
For professionals and executives, the definition of disability can be especially important. An own-occupation policy may provide benefits when the insured cannot perform the substantial and material duties of their regular occupation, even if they retain the ability to perform other work. For example, a surgeon may be unable to safely perform procedures because of a disabling hand condition while remaining capable of administrative or consulting work.
The insurer’s interpretation of the insured’s occupation, income, and functional limitations can significantly affect the claim. Our firm represents professionals facing disputes involving individual disability policies, including physicians, business owners, executives, and other specialized occupations.
Learn more about our firm’s representation in disability insurance claim denial cases.
What Should You Do After an Ameritas Disability Claim Denial?
Before submitting an appeal or additional information, consider the following steps:
- Obtain the complete insurance policy, including endorsements and riders.
- Preserve medical records, occupational documentation, and correspondence.
- Request the claim file and any applicable medical or vocational reviews.
- Identify all claim deadlines and contractual limitations.
- Consider having the claim reviewed before submitting a substantive appeal or additional information.
An attorney can help evaluate whether the insurer’s conclusions are supported by the evidence and consistent with the policy.
Can an Ameritas Disability Delay or Denial Constitute Insurance Bad Faith?
Under California law and most other states, insurers generally must handle covered claims reasonably and in good faith. Depending on the circumstances, potential bad faith issues may involve an unreasonable delay or denial, failure to conduct an adequate investigation, or improper termination of benefits. However, an unfavorable claim decision does not automatically establish insurance bad faith.
Whether additional remedies are available depends on the policy, governing law, insurer’s conduct, and specific facts. Our firm evaluates disputed claims to determine whether the insurer has breached its contractual obligations or whether additional legal claims may be appropriate. Learn more about insurance bad faith claims.
Our Experience With Disability Insurance Claim Denials and Ameritas
Pillsbury & Coleman has represented policyholders in substantial disability insurance disputes involving the wrongful denial of benefits and insurer bad faith. Pillsbury & Coleman obtained the largest disability insurance bad faith verdict in California history in Chapman v. UnumProvident Corporation. We have decades of experience and have prevailed against every major disability insurer in the country.
Recently, Pillsbury & Coleman filed disability insurance bad faith lawsuits on behalf of two separate Ameritas insureds whose claims were denied by Ameritas. In Wolske v. Ameritas, et al., Case No. D-202-CV-2026-07712, New Mexico, County of Bernalillo, we filed suit on behalf of a former Radiologist whose claim for Total Disability benefits was denied. In Lim v. Ameritas, et al., Case No. C26-02911, Contra Costa County, we filed suit on behalf of a former patent attorney whose claim for Total Disability benefits was also denied.
Frequently Asked Questions About Ameritas Disability Claim Denials
How long do I have to appeal a denied Ameritas disability claim?
For ERISA-governed disability claims, the appeal period generally must be at least 180 days. Individual policies may contain different procedures and deadlines. Do not assume that every Ameritas disability policy follows the same appeal requirements.
Can Ameritas terminate benefits after approving my claim?
An insurer may review ongoing eligibility and terminate benefits when the policy’s requirements are no longer satisfied. However, the decision must be consistent with the policy and applicable law. A termination may be challenged when the evidence supports continued disability.
What if my doctor says I cannot work but Ameritas denies my claim?
A treating physician’s opinion is important evidence, but the insurer may evaluate additional medical and occupational information. A dispute may involve how functional limitations affect your ability to perform your occupation. The complete medical and claim record should be reviewed before determining how to challenge the denial.
Can I receive disability benefits if I can perform some work?
Possibly. Certain policies provide residual or partial disability benefits when an insured can work in a reduced capacity but experiences a qualifying loss of income. Eligibility depends on the policy’s definitions, benefit provisions, and financial documentation.
Can I sue Ameritas for denying disability benefits?
Legal action may be available when benefits are wrongfully denied or terminated. ERISA-governed claims generally require completion of applicable administrative appeal procedures before litigation. Individually purchased policies may involve different contractual and state-law remedies.
What documents should I preserve after a disability denial?
Keep your insurance policy, denial letter, medical records, physician statements, occupational descriptions, financial records, and communications with Ameritas. These materials can help establish the nature of your disability and identify potential problems with the insurer’s decision.
Speak With a California Ameritas Disability Claim Denial Attorney
A denied disability claim can threaten your financial stability when you are already dealing with a serious medical condition. Pillsbury & Coleman, LLP represents policyholders in disability insurance disputes involving claim denials, benefit terminations, and insurance bad faith.
If Ameritas has denied or terminated your disability income benefits, contact our firm to discuss your claim and available legal options.
Call (415) 433-8000 to request a consultation.