Short and Long-Term Disability Plans
CAFS was founded specifically to provide independent final claim appeal processing for benefit plans, and in particular, the final claim appeal for disability plans. CAFS acts as an independent processor or fiduciary, under ERISA, to adjudicate short and long-term disability benefit final claim appeals. By assuming the important role as the claim appeal processor or fiduciary, CAFS reduces potential conflict of interest, and improves the quality and integrity of decision-making. We have designed our approach to fiduciary decision-making to be a better choice for sponsors of disability plans, regardless of how final appeals are currently being handled.
When your company outsources final disability claim appeals to CAFS, you have chosen an independent fiduciary that provides the highest quality processing and skilled claim analysis.
"Heightened scrutiny is required when an insurance company [or self-insured plan] is both plan administrator and funder…Potential self-dealing warrants that fiduciary…decisions be closely inspected." Pinto v. Reliance Std. Life Ins. Co., 214 F.3d 377 (3rd Cir. 2000).
A Prudent Final Claim Appeal Alternative
While third party claims administrators and insurance companies do have an important role as claims administrators, they are looked upon with suspicion when handling final claim appeals, and often do not and cannot provide the fresh, neutral, complete decision-making as required. This is especially true, because insurance companies and claims administrators are often looked upon with suspicion when they deny claims, and are seen as protecting their own process, when they “rubber stamp” prior decisions.
CAFS is a better alternative. The independence that CAFS delivers reduces liability and exposure, making CAFS a more efficient and effective alternative
Please note that CAFS does not provide any legal brokerage, asset management or accounting services and does not hold or control any plan assets. top
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