California Court Orders Hartford To Pay Long-Term Disability Benefits To A Telecommunications Manager

Many companies offer short and long-term disability insurance coverage to protect a portion of an employee’s monthly income in the event the employee is unable to work as a result of a sickness or injury. Employees pay the premiums for this insurance on a monthly basis so they’ll have something to fall back on if they ever become sick or injured. Of course, many individuals have a sense of security because of this. However, most employees are unaware that once a claim for disability benefits is submitted, the disability insurance company has a “structural conflict of interest”, as it is usually the long-term disability insurance company that both administers and pays any approved claim. This structural conflict is significant as a claim denial allows the insurance company to keep the money for itself and increase its profits. Fortunately for disability claimants, the courts are required to consider this structural conflict of interest as one of many potentially bias factors that inappropriately motivate a disability insurance company to deny disability benefits.

As a disability insurance attorney that has handled thousands of claims against every major disability insurance company, I am constantly trying to educate potential claimants about the tactics of disability insurers. A recent case is a victory for disability policyholders as it exposed the “signs of bias” exhibited by Hartford Life and Accident Insurance Company throughout its decision making process.

Click here to continue reading California Court Orders Hartford To Pay Long-Term Disability Benefits To A Telecommunications Manager

CIGNA/LINA Penalized By The California Department Of Insurance

Recently, the California Department of Insurance settled with LINA, a daughter company of CIGNA to the tune of $600,000. What was this penalty for? According to California Insurance Commissioner Steve Poizner, LINA was apparently ignoring certain claims that might have been valid disability claims.

Between January 1, 2005 and December 31, 2007 LINA improperly handled insurance claims. It seems that not only did LINA deny many cases before ever receiving the medical proof those clients were entitled to their insurance payouts but LINA ignored important information that may have reversed the denied claim on a number of accounts.

Click here to continue reading CIGNA/LINA Penalized By The California Department Of Insurance

Prudential Denies Long-Term Disability Benefits To A College Professor, But The California District Court Reverses the Claim Denial

The recently decided case of Barteau v. Prudential, 2009 WL 1505193 (C.D. Cal.) is a reminder of what ends Prudential will go to in denying a claim for benefits. Carl Barteau was an Assistant Professor of Mathematics at DeVry Institute of technology for almost eight years before becoming disabled. Mr. Barteau had suffered problems with his right eye since childhood. In 2002 he underwent surgery for glaucoma, which was complicated by a scratched cornea. As a result of the scratched cornea he was instructed to wear a replaceable contact lens and was reassured the eye would heal on its own. Soon after he began experiencing excruciating pain, and on January 7, 2003 he began treatment at UCLA. Biopsies of the eye were taken and showed evidence of eye fungus. On January 17, 2003, he became hospitalized and underwent surgery to remove a large part of the infection from his right eye. On February 22, 2003, he underwent a second surgery on his right eye. Following the second surgery he began to experience a lack of vision in his right eye and disabling light sensitivity in both eyes.

Click here to continue reading Prudential Denies Long-Term Disability Benefits To A College Professor, But The California District Court Reverses the Claim Denial

Judge Orders Prudential To Pay Account Manager $90,416 In Long-Term Disability Benefits

In, Lona v. Prudential, 2009 WL 801868 (S.D. Cal)., the Court determined that the opinions of three doctors hired by the insurance carrier to review the insured’s medical records did not carry as much weight as the opinions of three other doctors that physically examined the insured. This case shows that Prudential will continue to hire doctors to review a claimant’s disability file, until they have found the right doctor to provide the opinion they are looking for.

Click here to continue reading Judge Orders Prudential To Pay Account Manager $90,416 In Long-Term Disability Benefits