Disability Insurance Blog

Why Did Prudential Deny My Long Term Disability Claim?

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Wednesday, May 5th, 2021

If Prudential has denied your disability claim, it may have little to do with your claim, but more to do with the current environment.  Frankel & Newfield’s disability law firm has received many calls from American workers who have group disability insurance policies with Prudential Financials’ group disability business and they are being denied in large numbers. The increasingly aggressive practice is tied, we believe, to the reports that Prudential Financial is exploring selling a large part of its business, also known as its “full-service solutions” business. It is possible no sale will occur, but the fact that it has become public knowledge tells us there are big wheels turning in this company.

Your long or short term disability insurance claim may have gotten trapped in a very large company where big decisions are being made and profits are being placed ahead of fairness.  Many insurance companies are selling off portions or all of their group disability insurance business, and this always sparks a rush to find ways to boost balance sheets. Shedding liabilities, including long term disability claims, have become common practice by Prudential and other disability insurance companies.

Prudential Disability Insurance Claim Denials

If your LTD claim for Prudential disability benefits is denied, an appeal must be filed with Prudential. Doing this on your own is taking a big risk for yourself and your family. This process is neither reasonable nor simple. Frankel & Newfield has years of experience, legal knowledge, and tenacity: all three are needed for an appeal to succeed.

Here are a few steps you need to consider once you receive a disability denial:

Take note of the date of the letter and any dates listed in the letter. Your claim is probably an ERISA claim, if your disability benefit is part of your employee benefits package and you pay for it with withdrawals from your paychecks. This also means that there are very strict time requirements for filing your appeal.

ERISA disability appeals don’t go through civil proceedings. ERISA claims are governed by a special federal law and appeals go through an administrative process. There’s no judge, no jury and the only materials that can be considered are what’s in your claims file. This is why we recommend you call our office at 877-583-2524. The disability attorneys at Frankel & Newfield have years of experience in preparing claim files to serve dual purposes: to bolster your claim for the appeal and to prepare if a federal lawsuit is needed.

What Reasons Does Prudential Give for an ERISA Disability Appeal?

Your policy is a legal contract between the insurance company and typically your employer.  As a beneficiary of that policy, both you and the insurance company must meet the provisions of the policy. A disability attorney can see conditions and issues in your policy that may not seem important to you, but could be the difference between your receiving a monthly benefit and being denied permanently or having a limited benefit paid.

When preparing an ERISA disability appeal, the attorneys at Frankel & Newfield look for avenues to attack on the claim decision, seeking to destroy the basis of the determination.  Why would they deny your claim, when you and your doctors know that you cannot work? Knowing that there have been many wrongful denials of valid LTD ERISA disability claims by Prudential doesn’t solve your problem. You want a solution. We understand that.

In one case, no less than 16 doctors said that a disability claimant was disabled, while three doctors, all hired by Prudential, stated that the claimant was able to work. How could he have been denied, and why would Prudential put a disabled person through such a terrible process? For Prudential, the business of insurance is just that: business.

Here are some of the other reasons Prudential gives for denying disability claims:

There is insufficient medical evidence to support your claim. Just being diagnosed with an illness or a description of an injury is not enough for a claim to succeed. The medical evidence in an appeal must be as strong as possible. Frankel & Newfield works with treating physicians on a routine basis to ensure the correct and substantial documentation is presented. There may be tests that your own physician may not know about that are lacking; we work with medical specialists in many areas so we know what test results will best support your claim.

You claim does not meet our definition of disability. Your disability insurance policy has specific terms that describe exactly what disability is from the insurance company’s perspective. Your claim and all of its supporting documentation must be aligned with that definition.

Surveillance reports show you are not disabled. Once a claim has been filed, the disability insurance company begins looking for evidence of your activity level. Such investigation includes everything from looking at your social media postings to video surveillance when you leave your home to unannounced field visits. We have been telling clients since Facebook was launched not to post their activities on social media and to ask that their friends and family members also not post pictures or tag them on their own social media posts. We know you want to let your family know when you are having a good day, but this will hurt your claim.

Video surveillance is now as common as a self-scanning supermarket register. Videos can be taken from a parked car, without anyone having to sit in the car, or by a video drone that flies high enough that you wouldn’t notice its presence.

We advise clients to maintain a record of their appointments and any trips outside of their homes to counter any claims of activities that are indicative of a healthy, well person.

How Frankel & Newfield Helps Clients with Peace of Mind

The disability lawyers at Frankel & Newfield lift the burden of managing disability claims from people so they can address the more immediate concern of taking care of themselves. Our partners speak with the insurance companies, their attorneys and even the investigators hired by Prudential. Our clients repeatedly tell us how much they appreciate not having to engage in this battle on their own.  When they have questions, they call, and we talk with them. It’s that simple.

When your case is handled by Frankel & Newfield, you have the confidence of knowing that your case is being handled by a partner with decades of experience. We work closely with clients, so they know they are not alone in this battle.

If your claim has been denied by Prudential, we invite you to call us at 877-583-2524. Learn how we can help, and don’t wait – those time restrictions are real.

 

Jason A. Newfield

Written By:

Jason A. Newfield

Disability Insurance Attorney