Hartford sells group long term disability insurance for numerous Fortune 500 and other large companies, across many industries, and many of the long term disability insurance claims are wrongfully denied or terminated. If your claim has been denied or terminated, what can you do? Start by learning how it happens and how to protect your disability claim and secure your benefits.
If you’ve had a long-term disability insurance claim denied or terminated by The Hartford, you are probably surprised that your claim has been denied. Your doctor advised you to stop working and supported your claim for benefits. You filled out all the right forms in the application process. So why would The Hartford deny your long-term disability insurance claim? It may have little to do with you or your claim. Publicly available corporate disclosures from Hartford Life over the past 2 years supports legitimate claims of a pervasive culture of claim bias, due to pressures upon the claim personnel to achieve strong results. In these relevant disclosures, Hartford notes the significant challenges which COVID-19 has placed upon its various lines of businesses. Hartford also notes how various processes have helped “the company recognize(d] strong claim recoveries on prior incurral years” (which could inferentially mean legacy Aetna claims). These disclosures from Hartford share some insight toward a targeting of Aetna legacy claims for closure Hartford’s claim culture was successful (for its shareholders to the detriment of claimants), and created an aberration from norm in having a loss ratio for disability of 62.6% (an improvement of 10.3 points) – “due to higher claim recoveries on prior incurral years and lower claim incidence”. Throughout investor calls, Hartford’s leadership sought to assuage concerns of investors regarding the ability to “ensure” results from its disability business. Hartford’s CEO, Christopher Swift, noted that Hartford makes “3-year rate guarantees” and closely monitors the issues to “provide ourselves an additional margin or additional buffer for potentially more incidences”. A review of Hartford’s stock price demonstrates that it strongly reacts to the pressures which existed upon the stock, and how its stock price performance has been enhanced as a result of corporate “performance”. Further investor calls have continued to highlight the strong loss ratio and guidance that the “disability book of business remains quite strong with favorable claim recoveries and incidence trends”. Hartford’s CEO even had the boldness to publicly state that their margins were “stellar”, and took pride in stating “it feels good that we’re printing the numbers we are, but there’s pressures building, particularly from a competitive side, I could feel right now”.
Our attorneys represent people just like you every day who have found themselves in the same situation. They are too sick or injured to work, but their claim has been denied, or after being paid for some time, the claim is suddenly terminated. The “why” is easy – the fewer claims paid out, the more profitable an insurance company is. The “how” is a bit more complicated. As in “How do they get away with denying legitimate claims” and “How can I get my Hartford Disability Claim paid?” Let’s start with how Hartford, a billion-dollar Fortune 500 company, wrongfully denies disability claims. Like all of the big disability insurance companies (Unum, New York Life, Guardian), Hartford has a vested interest in minimizing its exposure to the cost of claims. To make this happen, Hartford has processes in place and an extensive number of internal employees and external contractors who review claims to control costs. The claim form you’ve submitted is first place where your claim is scrutinized. If you don’t know what the insurance company is looking for, or the conditions or phrases that send up red flags, you might very easily find claim trouble before your medical records are even reviewed.
Once you get passed some of the early red flags, next your claim has to make it through a gauntlet of medical reviewers. The person who denied your claim may be an in-house nurse who hasn’t seen a living patient in years or a doctor who sees only an extremely edited selection of your medical record. Or they may hire a “professional” – a medical doctor whose practice is largely Frankel & Newfield has represented people with medical records that could easily fill a small truck, yet only a selected number of results are given to a doctor for review. This is called “cherry-picking,” and as expected, it results in a doctor denying a claim. Another tactic is to have a doctor or nurse with zero experience with a particular disease assigned to review medical records. We have represented clients in cases where their treating physician is a leading authority for an illness. The medical doctor from the insurance company has a completely different specialty if they have a specialty at all and knows little or nothing about the claimant’s illness.
The Hartford has a “Proof of Claim” or “Notice” clause in its disability insurance policies, as do other disability insurance companies. If you miss a deadline, your claim can be denied. We know that disabled claimants aren’t always able to manage their claims; when you are too sick to work you are likely too sick to be making sure to meet deadlines and file paperwork on time. That’s our job. Yours is taking care of yourself.
Here is where an experienced team of disability attorneys makes a difference. Our free consultations often begin with a review of this provision of the disability policy. Disability is defined differently by different insurance companies and within different policies. Without knowing how Hartford defines disability in each case, it is difficult for the layperson to gain a full understanding of how they need to present their inability to work, and support their claim for benefits.
Among the many requests from Hartford for medical and financial records may be a request that you be present for what is called an IME. Frankel & Newfield advises clients to be mindful about these exams, which are anything but independent. Courts have agreed with our opinion—the doctor is usually one who has limited or no other medical practice aside from conducting medical exams. The Hartford, or another insurance company, like New York Life or Prudential, pays the doctor for the exam. How likely is a doctor to receive repeat business if their medical exams find the claimant does qualify for disability benefits? We have also seen doctor appointments made in locations that are extremely inconvenient for claimants. For someone who is extremely ill, it may not be possible to travel two or three hours to have an examination. Our recommendation is to bring a trusted friend or family member to the medical examination and if possible, record the appointment. Often, the reports from the doctors do not reflect the claimant’s experience. Having someone record the appointment on a cell phone, or at the very least, take handwritten notes throughout the appointment, provides some measure of self-protection during the exam.
Call our office for your free consultation at 877.583.2524 to learn how we can help you with your claim today. If Hartford has denied your disability insurance claim, a free consultation with our firm will help you understand what you’ll need to do to protect your benefits, what you can expect from Hartford in the weeks, months, and years ahead, and help you make an informed decision about your future.
Jason Newfield is a founding partner of the disability insurance law firm Frankel & Newfield. He has spent the majority of his legal career advocating for the rights of disabled workers. He has lectured other professionals, worked on a Federal Advisory committee, and published many articles in the field of disability insurance claims and litigation.
Secrets the Disability Insurance Companies Don't Want You to Know!