The disability attorneys at Marc Whitehead & Associates have helped thousands of disabled workers obtain the disability benefits they deserve after an insurance company unfairly denied their claims.
We recently filed suit on behalf of a 59 year old worker from Illinois who became severely disabled while covered under a long term disability insurance policy issued and administered by The Hartford.
Founded in 1810, The Hartford is one of America’s largest insurance companies, taking in billions in revenue each year. They provide a wide range of group insurance policies, including short term and long term disability insurance. The Hartford does business in Illinois and other states.
Other insurance companies with a large share of the disability market include The Hartford, Standard Insurance, SunLife, MetLife and Liberty Mutual, Provident, CNA, John Hancock, Colonial, AXA Equitable, New York Life, Guardian, Penn Mutual.
Our client, formerly employed as a Risk Control Consultant in Illinois, is currently disabled due to Degenerative lumbar/ spinal stenosis, Spondyolisthesis at L4-L5, Systemic Lupus (SLE), Glaucoma, Cataracts, and thinning bones as well as a history of bilateral knee replacements, back surgery, left foot surgery, bilateral carpel tunnel surgery, and removal of the left kidney due to renal carcinoma.
Despite his many medical problems, The Hartford decided our client could still work and denied his claim for disability benefits.
Claimants must prove the insurance company “Abused its Discretion”
In a disability insurance claim brought under state law, the disabled claimant only has to prove it is “more likely than not” that they are disabled. This generally only applies to individually purchased policies. Most policies however are obtained through a worker’s “Employee Benefit Plan.”
Like most group employee insurance plans, our client’s disability policy was governed by ERISA. ERISA stands for the Employee Retirement Income Security Act of 1974. It’s a federal law that regulates the handling of Employee Benefit Plans and the remedies of the beneficiaries of these Plans. It applies to all employee benefit plans established or maintained by an employer engaged in commerce or by an employee organization representing employees engaged in commerce. Among other things, ERISA gives policyholders the right to appeal an insurer’s decision to deny benefits – in Federal Court, if necessary.
In most claims brought under ERISA, the claimant must prove that the insurance carrier “Abused its Discretion” when it denied your claim. This is a very tough standard requiring you to show the insurance company had “No Reasonable Basis” for denying your claim. An example might be if you had three doctors that said you were disabled and the insurance company only had one that said you were not. The insurance company could legally argue that they had a “reasonable basis” to deny your claim based on their one doctor, in spite of your three.
After appealing The Hartford’s denial of benefits to no avail, out client was notified on August 18, 2010 that he had exhausted all administrative remedies and the insurance company would consider no further claims or evidence. The Hartford, in its final denial, not only ignored the professional opinions of our client’s treating physicians, but also chose to dismiss the well documented limitations that he suffers from, including the effects his impairments have on his ability to engage in work activities.
Since our client had exhausted all available administrative remedies, he was left with no choice but to file a lawsuit to obtain the disability benefits he was rightfully owed.
Suit was filed in federal court in Illinois pursuant to 28 U.S.C. § 1331 (“The district courts shall have original jurisdiction of all civil actions arising under the Constitution, laws, or treaties of the United States”) to our client’s rights under the ERISA.
The judge in this case sided with our client and that The Hartford had no reasonable basis for denying your claim must pay him the disability benefits he was entitled to under his policy.
Don’t Let the Hartford Abuse Its Discretion – Fight Back
Many disability insurance companies, including The Hartford, Unum, Cigna, Aetna and Prudential often write their policies to take full advantage of ERISA’s rules and regulations in order to make it difficult for a disabled person to get receive benefits or to keep them for the entire length of the term of their insurance policy.
Do you believe the insurance company abused its discretion when it denied your claim? The board certified Texas disability attorneys at Marc Whitehead & Associates are here to protect your rights and fight to get you every penny you are owed. We’ve been representing disabled workers and veterans for over 25 years and know all the tricks the insurance companies use to try to discourage their clients from seeking the benefits they are owed. Don’t let the insurance companies deprive you of the benefits you deserve — contact The Hardford disability lawyers at Marc Whitehead & Associates at www.DisabilityDenials.com or call us at to schedule a free initial consultation meeting to discuss your case and legal options.
For more information, you can download Marc Whitehead’s free E-book, “Disability Insurance Policies-How to Unravel the Mystery and Prove Your Claim.”