In this video Marc Whitehead, a Board Certified Disability Attorney, explains that a Hartford insurance denial can, in fact, be over turned.
Marc Whitehead & Associates recently filed a lawsuit against ERISA on behalf of our New York client after the Hartford determined that, after paying them Long Term Disability benefits for over three years for her relapsing and remitting multiple sclerosis. She no longer met the plans definition of disability and was no longer eligible for continued benefits.
The New York Court reviewed the administrative record and found that the Hartford abused its discretion by denying our clients disability continued disability.
They found that there were three ways the Hartford wrongfully denied our clients disability claim:
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Failure to consider the Social Security Administrations notice of Award.
After Hartford approved her benefits it offered her assistance in applying for her Social Security Benefits. With the Hartford’s assistance the Social Security rendered a fully favorable decision and our client was awarded benefits.
Following that the Hartford offset her Long Term Disability benefits as a result of her receiving Social Security Benefits. However when the Hartford reviewed our clients claim and ultimately denied it, they didn’t give the Social Security Award any weight.
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The Hartford did not consider contrary medical evidence regarding multiple sclerosis.
The New York Judge acknowledged that while the Hartford was not required to give special weight to the opinion of our clients treating physicians.
The Hartford is not permitted to rely on medical reports which supports it’s denial of benefits. Without further investigation and consideration of more detail reports which provided medical evidence to the contrary.
Our client was treated by a neurologist just prior to Hartford’s denial of benefits. The Hartford had two physicians conduct peer reviews of our clients medical records. In both reviews the physicians failed to mention the documentation of the neurologist regarding the MRI findings.
The Court found that the Hartford’s decision to rely on the opinions of its peer review physicians unfair due to the fact that the neurologist discussed an important finding that was significant to her limitations and her disability. Which Hartford’s peer review physicians entirely failed to address.
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The Hartford was wrong to rely on surveillance video. While the Hartford was paying our client her Long Term Disability Benefits it conducted yearly reviews of her claim to determine continuing eligibility of her benefits.
During her last review our client gave information to Hartford that she was not able to preform certain activities and that she required assistance from her husband and mother. In contrast her neurologist informed the Hartford that she did not require assistance to preform daily activities.
In an effort to sort this out, the Hartford conducted video surveillance to determine what activities she was actually capable of performing.
The Court found that the Hartford relied heavily on the surveillance video in making its determination of denying benefits. The court stated that the video surveillance did not contradict her statement that she was not able to sit for most of a work day nor did the video show that she was unable to perform tasks related to standing or walking for 8 hours a day and 40 hours per week.
The Court Granted our clients request for summary rejudgment and awarded her benefits and attorneys fees. With judgment being help until the amount of benefits due was determined.
Our Firm has handled claims against the Hartford for over 20 years and would be happy to assist you too.
