Who Really Decides Your Equitable Long-term Disability Claim?
The Hidden Claims System Behind Equitable Financial Long-Term Disability Insurance Policies
When people buy long-term disability insurance, they believe the insurance company named on the policy will fairly evaluate their claim and pay benefits if they become disabled. What many Equitable policyholders do not realize is that the company whose name appears on the policy is often not the company making the claim decisions.
For many legacy long-term disability insurance policies issued by The Equitable Life Assurance Society, the day-to-day handling of long-term disability claims has been outsourced to a third-party administrator. In 1859, The Equitable Life Assurance Society of the United States incorporated in the State of New York.
In 1999, Equitable decided to financially exit the individual disability insurance income business by selling its individual disability income insurance to another insurance company. It entered into a complicated reinsurance transaction with a reinsurer called Centre Life which is controlled by Zurich Insurance Group, Ltd. Equitable hired Disability Management Services, Inc., in Springfield, Massachusetts (DMS) to manage the day-to-day business of administering claims. Today, those same claims are handled by Davies Life & Health, the corporate successor to DMS. Davies Life & Health, Inc., is controlled by a private equity firm called BC Partners. Of interest, Centre Life had its headquarters at the same office of DMS.
This outsourced structure affects every stage of a long-term disability from the initial application, to benefit termination, to appeals. It also raises important legal and ethical questions about fairness, transparency, and accountability.
Learn how this system works, why it matters, and what Equitable long-term disability policyholders should know when their benefits are denied, delayed, or terminated.
What Does It Mean that Equitable Is the Insurer but Not the Claims Administrator.
Equitable is the insurance company that issued your long-term disability policy. It drafted the contract, collected your premiums, and remains legally responsible for paying benefits when you meet the policy’s definition of disability.
However, Equitable does not personally perform the daily claims functions for many of its long-term disability policies. Instead, it has delegated those responsibilities to an outside company.
That company is now Davies Life & Health.
In practical terms, this means:
- Equitable retains the financial risk and ultimate legal responsibility.
- Davies Life & Health performs the operational work: claim reviews, medical record analysis, surveillance coordination, vocational assessments, and decisions on approvals, denials, and terminations.
Although claim letters often appear on Equitable letterhead, the work behind the scenes is performed by Davies personnel acting under contract.
Equitable’s How the Outsourcing Structure Developed
For many years, Equitable relied on Disability Management Services (DMS) to manage long-term disability claims. DMS functioned as a specialized claims vendor for multiple insurance companies, handling large volumes of long-term disability claims.
DMS was later acquired and rebranded under the Davies Group, a global insurance services company. Today, DMS operates as Davies Life & Health, continuing the same claims management role for Equitable’s legacy long-term disability blocks.
For policyholders, this transition often occurred quietly. There were no renegotiation of policy terms and no meaningful disclosure that a different corporate entity would now control their claim. Yet the people reviewing medical records, deciding whether a claimant is “disabled,” and ruling on appeals are not Equitable employees they are Davies employees.
What is the Job of a Third-Party Claims Administrator?
A third-party administrator (TPA) like Davies performs nearly every function traditionally associated with an insurance claims department, including:
- Receiving and processing long-term disability claim applications
- Requesting medical records from physicians and hospitals
- Communicating with claimants, employers, and doctors
- Arranging “independent” medical examinations and record reviews
- Evaluating whether claimants meet the policy’s definition of disability
- Approving, denying, or terminating benefits
- Handling administrative appeals
- Preparing the claim file used in litigation
To be clear, this means that Davies controls the entire claim lifecycle of your claim not Equitable. Equitable, while still the insurer, is largely removed from direct interaction with the policyholder.
Why This Outsourced Structure Matters is Tricky
At first glance, outsourcing may seem like a routine business practice. But in long-term disability insurance, this structure can significantly affect claim outcomes.
The Decision Maker Is Not Really the Insurer You Chose
Policyholders purchase insurance from Equitable, believing that Equitable will evaluate claims in good faith. Instead, their claim is decided by a separate corporation whose business model is based on handling claims for insurers.
This disconnect often leaves claimants unsure who is truly responsible when problems arise.
Possible Incentives for the TPA to deny or limit claims
Third-party administrators are paid by insurance companies under contracts that often emphasize efficiency and cost control. Although Davies Life & Health does not directly pay benefits, its continued business depends on insurer satisfaction. This can create powerful incentives to limit claim approvals and shorten benefit durations. BC Partners’ own public materials describe its approach to portfolio companies in terms that directly relate to claims administration. BC Partners discloses its value creation strategy centers on “operational improvement,” “optimization and efficiency,” and deploying “pricing” expertise across portfolio companies. For an insurance administrator, whose revenue comes from administrative fees charged to insurers and reinsurers, “value creation” and “margin improvement” can translate directly into pressure to reduce claims costs — because the administrator’s clients (insurers and reinsurers) are paying it precisely to manage and reduce their claims exposure. BC Partners acquired its majority stake in Davies for approximately £1.2 billion ($1.66 billion) including debt. BC Partners’ recent exits from other portfolio companies have delivered returns of 2.5–3x multiple on invested capital (MOIC). This means BC Partners expects to sell Davies for at least $4–5 billion to meet its return targets — a figure confirmed by reporting in May 2025 that BC Partners had targeted a valuation of £4 billion ($5.3 billion) for a potential exit. BC bought Davies with debt. Highly leveraged portfolio companies face greater financial pressure to service expensive debt, which could lead to increased cost-cutting.
Appeals Reviewed by the Same Organization doesn’t Seem Fair
When a claim is denied, the appeal is not reviewed by an independent body. It is reviewed by the same claims administrator that issued the denial. This means the company is effectively asked to confirm its own decision.
For claimants, this can feel like an uphill battle before it even begins.
Common Roadblocks Equitable Policyholders Experience
Many Equitable long-term disability claimants report similar issues under this system:
- Repeated requests for medical records that have already been provided
- Changing claim handlers, leading to inconsistent decisions
- Vocational assessments that ignore real-world job demands
- Surveillance or social media monitoring used out of context
- Delayed decisions that cause financial hardship
- Sudden benefit terminations after years of payment
These tactics often result in unnecessary stress, financial instability, and prolonged disputes especially for disabled individuals who can no longer work.
Legally Equitable Is Still Responsible
Even though Equitable has outsourced claims handling, it cannot outsource its legal obligations. Courts have consistently held that an insurer is responsible for the conduct of its agents and vendors.
If a claim is wrongfully denied or delayed, Equitable remains the legally accountable party, even if the decision was made by Davies.
This is a critical point for policyholders: you did not contract with Davies. You contracted with Equitable. The insurer cannot avoid responsibility by pointing to its vendor.
How This Structure Affects Litigation
When disputes reach court, the administrative record is typically prepared by the third-party administrator. This means:
- The claim file reflects the vendor’s interpretations
- Important medical evidence may be discounted or mischaracterized
- Procedural errors by the administrator are often attributed to the insurer
Understanding this structure is essential when preparing an appeal or legal claim.
What You as A Policyholder Can Do
If you have an Equitable long-term disability policy and your claim is denied or terminated:
- Request the complete claim file
- Document every communication
- Submit comprehensive medical evidence
- Address every stated reason for denial
- Consider engaging a knowledgeable long-term disability attorney
Note: The appeals stage is often the last chance to build a record that can be used in court.
Transparency and Accountability Are Essential
Long-term disability insurance exists to protect people when they are most vulnerable. When claims are controlled by outsourced vendors, transparency and accountability become even more important.
Policyholders deserve to know who is deciding their claim, how those decisions are made, and who is ultimately responsible.
To Review: This is How Equitable’s Long-Term Disability Claim Process Works
- Equitable Financial Life Insurance Company is the insurer and remains legally responsible for long-term disability benefits.
- Davies Life & Health, successor to DMS, performs the day-to-day claims handling and decision-making.
- This structure can affect fairness, speed, and transparency in long-term disability claims.
- Despite outsourcing, Equitable remains accountable for every claim decision.
Understanding this system empowers policyholders to protect their rights and pursue the benefits they were promised.
Take Action Today: Speak With Jonathan Feigenbaum a Winning Long-term Disability Insurance Lawyer
If your Equitable long-term disability claim has been denied, delayed, or terminated, you do not have to face the system alone.
Long-term disability insurance companies and their third-party administrators rely on complex policy language, procedural traps, and administrative hurdles that can overwhelm even the most diligent claimant.
Once a denial is issued, your appeal may be your last opportunity to submit evidence that can later be used in court. Mistakes made at this stage can permanently damage your case.
An experienced long-term disability insurance attorney can help in the following ways by:
- Analyzing your policy and the true reason your claim was denied
- Identifying procedural and legal violations in the claims process
- Gathering and present the medical and vocational evidence needed to support your claim
- Handling communications with the claimadministrator on your behalf
- Preparing a strong administrative appeal or legal action to pursue the benefits you deserve
- Offering emotional support and guiding through the process
Don’t Delay
Strict deadlines apply to long-term disability insurance appeals. Waiting too long or submitting an incomplete appeal can cost you your right to benefits.
Why Hire Jonathan M. Feigenbaum?
Choosing the right legal representation is the single most important decision you will make in your disability journey.
- 30+ Years of Experience: Mr. Feigenbaum has seen every trick in the insurer’s playbook.
- A National Reputation: Based in Boston but representing clients across the U.S., he is a Senior Editor of the leading treatise on employee benefits law (Bloomberg BNA’s Employee Benefits Law).
- No Stone Unturned: From analyzing your specific policy language to hiring the right medical experts, he handles the heavy lifting so you can focus on pacing and recovery.
- Personalized Advocacy: You aren’t just a file. Mr. Feigenbaum understands the emotional toll of having your integrity questioned by an insurance adjuster.
Call today 617-357-9700 and receive a complimentary consultation.
