Our client, a Global Product Manager with a large international bank, suffers from a painful orthopedic condition that makes it impossible for him to perform in his job. Hartford went after his disability insurance benefits on several fronts, and we fought back and won.
They started with a peer review, where an outside company hired by the insurance company engages one of its repeat offending paper reviewing doctors to perform a selective review our client’s medical records. We had worked with our client’s doctors to make sure that their files properly and specifically documented not just his condition, but the severe limitations that his condition created. Our doctors swiftly and thoroughly rebutted the insurance company doctors’ claims.
We followed with an aggressive attack on the peer reviewing doctor’s opinions, which was clearly falsifying his diagnosis and failing to accurately review medical records. The paper reviewing doctor’s opinions were slanted by the peer review company in order to give the insurance company only what it wanted, and not the unbiased and honest review that they are allegedly hired to provide and which is legally required by ERISA, a federal law.
Our next level of attack involved a rebuttal of the insurance company’s surveillance, which had videotaped our client in his yard, mowing the lawn for a few minutes. We forcefully attacked their surveillance, relying upon a recent Good Morning America broadcast and case law that revealed the treacherous use of surveillance on disability insurance claimants by Hartford and other insurers.
The results speak for themselves. Our client’s claim has been reinstated, and he received full back benefits and reinstatement to his employer’s other employee benefits.