If Prudential or another insurance company has denied your claim for long term disability benefits, state and federal laws give you the right to appeal that decision. However, losing your appeal could cost you the benefits you need and deserve.
You’ll want to take every step possible to ensure your success in appealing a Prudential disability claims denial. The first step is hiring a skilled insurance lawyer to handle your appeal. Marc Whitehead & Associates helped thousands of clients obtain the LTD disability benefits they deserve after being denied by Prudential and other insurance companies. We know how to prepare an appeal that fully documents your disability and how it affects your ability to work. In addition we are here to protect your rights during the appeals process to guarantee you get a fair hearing from the insurance company review board – and we’re willing to take the insurance company to court if they don’t!
The Prudential Insurance Company of America
The Prudential Insurance Company of America is the trading name of Prudential Finance, Inc. A Fortune 500 company, Prudential has been around since 1875. Their products and services include life insurance, asset management, mutual funds, pension and retirement related investment, annuity and real estate. Prudential is the largest insurance company in the US and the second largest provider of group life insurance in the U.S. and a leading carrier of short term and long-term disability insurance.
Prudential’s long term disability coverage often takes over where the short term disability policy ends, replacing part of a policyholder’s salary if they become disabled for a long period of time. The employer may pay these group disability plans, or employee and employer may share the costs of coverage.
Prudential Disability Claims Denial Disputes
Because these are group policies, most lawsuits that are filed to appeal Prudential disability claims denial are filed under the Employee Retirement Income Security Act (ERISA).
The Employee Retirement Income Security Act of 1974, more commonly known as ERISA, is a federal law enacted by Congress that establishes minimum standards designed to protect the retirement, health, and other welfare benefit plans (life insurance, disability insurance, etc.) of private industry employees from fiduciary misuse.
While ERISA gives policyholders the right to appeal a decision to deny benefits, the insurance companies often use its complex rules and regulations to make it difficult for a disabled worker to mount an effective appeal. Failing to meet even one of the eligibility requirements of your Prudential ERISA regulated employee health benefits plan could result in your claim being denied with no further chance of appeal.
Prudential has a financial incentive to deny a policyholder’s claim for disability benefits. They deny most claims during the initial review process. Why not? If a state or federal court overturns their denial and makes them pay, in most cases there is no punishment under ERISA statutes. They would only have to pay out what they owed you in the first place.
Unfortunately, it’s a calculation that usually pays off. You’d be surprised at how many people who rightfully deserve and desperately need their benefits just give up when their claim is initially denied. Most are unaware that they can appeal this decision or what it takes to successfully appeal Prudential’s denial.
Another one of Prudential tactics is to offer a lump sum settlement or buyout of a policyholder’s disability policy. While a large upfront settlement may sound attractive, a buyout is often a way for the insurance company to keep from paying additional hundreds of thousands of dollars that may be legally accessible to the policyholder. Before making such an agreement, policyholders should make sure the amount being offered fully covers the costs of their disability, including future medical and living expenses.
Unfair, Biased and Unreasonable
There have been several court cases in recent years alleging that Prudential’s denial of disability benefits is unfair, biased or unreasonable:
A policyholder was approved by Prudential to receive long-term disability payments. After 24 months, Prudential reviewed the plaintiff’s eligibility and determined that the plaintiff no longer satisfied the definition of disability under the policy language. However, the plaintiff was deemed disabled by the Social Security Administration (using the same medical records submitted to Prudential).
A claimant was receiving short term disability coverage from Prudential. When the short term coverage ran out, Prudential denied the long term disability payments, arguing that the plaintiff’s medical records did not support the plaintiff’s claim of total disability.
In a lawsuit for long-term disability, Prudential acted as both the payer of the insurance and the claims administrator for the plan. When Prudential denied the claim for long-term disability, the plaintiff alleged that Prudential acted in conflict of interest by serving as fiduciary, insurance provider and claims administrator.
Don’t Let Prudential Deny You the LTD Benefits You Deserve
When appealing Prudential’s denial of LTD benefits, it’s critical to hire disability claims lawyers who possess the resources and experience to demonstrate to the court that you are in fact disabled under the terms of your policy.
If Prudential has wrongfully denied your disability payments, Marc Whitehead & Associates are here to help you fight back. We’re a national disability law firm with significant experience representing Prudential claims. We’ve represented clients all over the U.S. who have had they disability benefits claims unfairly denied by an insurance company.
For experienced help with Prudential disability claims denial, call Marc Whitehead at 800-562-9830 to request a free consultation with an LTD benefits claim lawyer today. We’ll evaluate your case, answer any questions you might have, explain your rights and the ways we can help with your disability claim.