Prudential is a large global insurance company that insures more than 50 million people in more than 40 countries, and has $1.5 trillion in assets under management. The company website boasts that it ranks number one on Fortune magazine’s “World Most Admired Companies” list and is the second largest seller of individual life insurance in the world. With those kind of high standards, you might think that disability insurance policyowners are treated fairly, but in our experience, this is not always the case.
There have been many lawsuits against Prudential as a direct result of deserving disability claimants having their short and long-term claims denied or terminated. Prudential is known for certain typical practice, including hiring “paid guns” – – physicians and third-party claim reviewing companies who are well paid by the insurance company. We have battled against these experts-for-hire many times – and they know how aggressively we fight for our clients.
Many of the disability insurance policies sold by Prudential are group policies, provided by companies to their employees as part of a group benefits package. These benefits are regulated by a federal law that places strict limits on what materials can be considered in an appeal against the claim denial, how much time is given for an appeal to be made, and the appeals process itself. The law, known as ERISA, was created in 1972 to protect employees from employers who raided pension accounts. But the disability insurance sector has twisted this law’s intent to protect employees.
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Relying on the disability insurance company to come through with no challenges along the way can lead to significant financial implications. Frankel & Newfield has found that Prudential disability claims can be tricky to navigate. It is important to prepare the application to avoid needing to file an appeal of a denial. But this does not always happen.
If you’ve never filed a claim for disability insurance, you may not know what materials are key to proving your Prudential disability claim. Having an experienced disability law firm on your side from the very start will give you the peace of mind that your claim will be in good hands and your rights protected.
Frankel & Newfield has represented so many Prudential disability insurance claimants that we know the strategies the company uses to defeat claims. Remember that the moment you file a claim, the company is seeking to build a case against your claim. The tactics used by Prudential are also used by other disability insurance companies, but Prudential is especially fierce when it comes to medical records and care.
First, make sure you have an original disability insurance policy if through your employer. If a private policy (like the AICPA policy sold by Prudential), you need the policy that you purchased – the original. Over time, disability policies change, and a generous policy that was issued some ten or twenty years ago will not have the same provisions as one issued two or three years ago. Ensure your claim is governed by the correct policy.
Prudential often denies valid disability claims. It’s not news, but when it’s your claim being denied, it’s a frightening prospect. Your medical reports are a critical piece in your defense. That’s sometimes the problem of submitting a disability claim online without the help of an experienced disability insurance attorney. You may not feel up to scanning all of your medical records, creating new documents and including them in your online application. But without every bit of evidence supporting your claim, it becomes easier for the claims adjuster to find a reason to deny or delay your claim.
With the help of a disability insurance attorney, the medical records that support your claim will be prepared and submitted in their entirety, so there is less wiggle room for the claims adjuster.Ready To Talk?
Efficiency in handling claimant paperwork is low on the list of importance at Prudential. Documents sent by email, fax or even overnight delivery mysteriously get lost between mailrooms and claims adjusters. Claimants are told their paperwork never arrived. Or the call to confirm receipt of the paperwork gets switched from desk to desk in what feels like a phone tag nightmare. No one knows where your records went, and no one seems to care.
Next to losing your paperwork, Prudential’s repeated requests for more and more paperwork – from both you and your doctor – is another technique that makes claimants frustrated. Your disability policy states exactly what documents Prudential is entitled to receive when considering your claim. But what are you supposed to do when you are asked to provide documents and are told that if you don’t provide them, your claim is going to be dismissed for lack of cooperation? How can you ensure your rights?
We believe that the poor claimant service is a deliberate tactic, as are claim delays. Prudential is counting on a certain number of claimants being too ill to fight back. Other claimants will not have the mental or emotional stamina to maintain a long-term fight to assert their claim. If Prudential pays out less money because you’ve given up, they win. We don’t give up. We work closely with our client’s treating physicians and ensure that your medical records and other documents are tracked and received by Prudential employees.
Despite multiple surgeries and powerful pain medications, our client could not continue to work as a financial advisor in a prestigious investment house. Prudential paid benefits for four months and then terminated his claim. A seriously flawed claim review was the reason – but it took an aggressive appeal by Frankel& Newfield to get him back on claim.
Prudential has a full roster of medical doctors who review claims on behalf of the insurance company giant and provide their client – the insurance company – with their opinion of whether or not a claimant is truly disabled. These doctors never meet you, and they don’t always receive your entire medical record. The claims managers select the documents they want the doctors to review. Is it any wonder that a doctor whose salary depends upon an insurance company is going to report that claimants are not too disabled to work?
This built-in conflict makes it impossible for us to trust the insurance company doctors’ reports, and it should be concerning for you too.
A Prudential claimant suffered from migraines and cluster headaches was on claim for a year when Prudential sent a letter saying his benefits were being terminated. He had just been approved for Social Security Disability, so being denied by Prudential didn’t make sense. Despite a rigorous regimen, Prudential said that he was ready to return to work. Given the high-pressure position of his job as Senior Director of Technical and Commercial Operations for a multi-location company, he was in no way able to perform at the high cognitive level required in such a demanding position. Frankel & Newfield fought back with an aggressive appeal, based on a two-pronged approach: our client’s detailed medical records and Prudential’s use of a doctor who is known in the disability community for serving as an insurance disability consultant who hasn’t seen a live patient in at least a decade. Our appeal succeeded, and our client was paid what he was due. We continue to monitor his claim to ensure that he continues to receive his payment. The entire case is described here.
Frankel & Newfield has represented claimants who were being treated by leading specialists in their field, only to be told that the person treating their disability was not knowledgeable enough to provide a proper evaluation of their status. At the same time, we have represented claimants whose medical records were reviewed by an insurance doctor with absolutely no experience or knowledge whatsoever about a highly complex disease, who said that the claimant was not really suffering from this disease.
If you have submitted your application for disability insurance and you receive a denial based on your medical records, don’t accept it as a final decision. Call our office at 877-583-2524 for a free consultation about your claim. We can review the denial, discuss your situation and provide you with our opinion on your best options.
Prudential denied a claim for benefits for a high-level financial services executive who was a cancer survivor battling several chronic conditions. Frankel & Newfield attacked Prudential’s claim practices in a successful appeal that lambasted Prudential’s use of an outside medical review company known for having a highly biased reviews that are supposed to be independent. We won the appeal.
You’ll work directly with a partner with years of experience. Both Jason Frankel and Justin Newfield have achieved the highest ratings from professional rating publishers including Martindale, Super Lawyers and Avvo. Their personal attention to claimants who have been denied or terminated by Prudential has made a difference in their lives. Read a select group of our client’s testimonials here.
When it comes to lump sum disability buyouts, Prudential has a “Take It, That’s All We’re Giving” approach.
Any long-term disability insurance company seeking a to rid itself of a claimant through a lump-sum disability buy-out enters negotiations backed by financial information from a team of economists, actuaries and vocational analysts. They are skilled in determining everything from the expected rate of compensation to the interest rate and investments that the company would expect to receive from the amount of the payout, and many other financial elements.
In most negotiations, there is an expected understanding that the first offer will be the lowest, and that the two parties will work to meet a point in the middle that leaves both parties slightly dissatisfied.
Not Prudential. “This is the number and this is the only number” is the standard Prudential position. We draw on our years of experience with disability insurance buy-out negotiations to maintain our position that our client deserves the full value of their policy. Backing down is not an option.Ready To Talk?
All long-term disability insurance claimants on claim with Prudential should carefully consider whether Prudential has requested any further information or medical exams that may indicate the company is considering terminating their claim.
Regardless of when your long-term disability insurance benefits were denied or terminated, you need the skilled guidance of an experienced disability insurance attorney that has represented Prudential claimants.
Call our office today for a free consultation at 877-LTD-CLAIM (877-583-2524). Frankel & Newfield represents ERISA clients nationwide.
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