The use of Claim Appeal Fiduciary Services, Inc. to process final claim appeals for your benefit plans is not only a clear best practice, but also delivers only advantages to your plan participants. Despite the best of intentions, companies that sponsor these plans, or insurance companies that make money selling insurance, are looked upon with suspicion when they process their own claim appeals. When any entity handles all levels of appeal, it is difficult to establish that the appeal is handled by a person or entity that is not subordinate to the prior decision-maker, as required by the rules. In such a case there remains a strong perception of self-dealing. This lack of independence in the appeal process negatively impacts the integrity of the plan, increases risk and destabilizes the costs of providing valuable employee benefits.
There are no disadvantages to using CAFS to process final claim appeals for your medical, short and long-term disability, pension, and other plans. Indeed, with CAFS’ fully integrated approach, your benefit plans will operate more efficiently and with more integrity.