California Court holds that Hartford Abused Its Discretion in Denying employee LTD Benefits

Claimants become frustrated and feel helpless when their disability benefits are cut off by their insurance company with the explanation that they no longer meet the definition of disability when their own treating physicians documented that they were totally disabled and unable to work in even a sedentary occupation. It has become common practice for insurance companies to deny claims based on opinions from physicians paid by insurance companies to conduct paper reviews and render opinions that the claimant is no longer disabled.

How can these doctors possibly understand the claimant’s medical condition when they have never met, spoke to or examined them? How is it fair that these doctors can cherry pick which medical records they want to consider during the review process and ignore the records that are supportive of a claimant’s disability? Insurance companies are hiring doctors who often conduct incomplete records reviews, discount relevant information, and misinterpret test results to achieve the ultimate goal of denying a claiming his or her disability benefits. Fortunately some courts are not allowing these insurance companies to get away with this abuse of discretion.

This very scenario occurred in a case out of California called Stout v. Hartford Life and Accident Insurance. The Plaintiff in Stout worked for as a senior technical program manager when she began making errors at work. She was experiencing confusion, fatigue, memory loss and pain. She was eventually diagnosed with an autoimmune disorder called Sjogren’s syndrome. She applied for disability benefits when her physicians told her she could no longer work.

Hartford denied her claim stating that according to their hired physicians, there was not enough medical evidence to support her inability to work in her own occupation, completely disregarding the opinions of her treating physicians who all rendered the opinion that she was disabled.

Hartford Relies on Flawed Reports In Denial of Plaintiff’s Benefits

The Court in Stout was clearly unhappy with the review performed by Hartford’s hired doctors who focused solely on the Plaintiff’s cognitive and physical conditions in isolation, never considering their cumulative effect on the Plaintiff’s ability to perform her job. The court was also critical of Hartford’s failure to have their physicians personally examine the Plaintiff or even speak to her treating physicians. Hartford’s hired doctors rendered opinions in complete contradiction to the Plaintiff’s treating doctors without ever explaining the reason why their opinions differed.

According to the Court, Hartford’s reliance on these flawed reports shows that it abused its discretion in terminating Plaintiffs claim for LTD benefits under the “own occupation” standard citing to Caplan 544 F.Supp 2d at 991-93 (holding that a plan administrator abused its discretion by relying on an expert report that showed a “total disregard for the conclusions of the Plaintiff’s treating physicians… and failed to credit the objective evidence of the claimants condition.” In addition Hartford’s attempt to rely on 2 hours of surveillance conducted during a six day period on the Plaintiff, where most of the footage depicted her grocery shopping and at the dentist was clearly insufficient to show she was capable of full time work in her own occupation.

Fortunately for the claimant, with the help of Plaintiff’s counsel, the California Judge saw through Hartford’s smoke and mirrors and held Hartford accountable for paying the claimant her past benefits she rightfully deserved remanding her claim back to Hartford for determination of future benefits.

If you or a family member have been wrongfully denied benefits by your insurance carrier please call Dell & Schaefer, our attorneys would be happy to assist you. Learn why the Hartford lawsuits are challenging for disability claimants.

For more Hartford cases and user comments, please visit this page.

Leave a comment or ask us a question

Questions About Hiring Us

Do you help Hartford claimants nationwide?

We represent Hartford clients nationwide and we encourage you to contact us for a FREE immediate phone consultation with one of our experienced disability insurance attorneys.

Can you help with a Hartford disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Hartford. We have helped thousands of disability insurance claimants nationwide with monthly disability benefits. With more than 40 years of disability insurance experience we have helped individuals in almost every occupation and we are familiar with the disability income policies offered by Hartford.

How do you help Hartford claimants?

Our lawyers help individuals that have either purchased a Hartford long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer.

Our experienced lawyers can assist with Hartford:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
  • ERISA and Non-ERISA Disability Benefit Lawsuits
  • Applying For Short or Long Term Disability Benefits
  • Daily Handling & Management of Your Disability Claim
  • Disability Insurance Lump-Sum Buyout or Settlement Negotiations

Do you work in my state?

Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.

What are your fees?

Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.

The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.

In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.

Do I have to come to your office to work with your law firm?

No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via telephone, e-mail, fax, sessions, or Skype. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.

How can I contact you?

When you call us during normal business hours you will immediately speak with a disability attorney. We can be reached at 800-682-8331 or by email. Lawyer and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.

Dell & Schaefer Client Reviews   *****

Antoine P.

After my insurance company arbitrarily decided to close my disability benefits I contacted several firms to handle my case. I was impressed with Attorney Rachel Alters who took my call personally. She was direct, knowledgeable and compassionate at the same time. Her firm was responsive and I felt I had (finally) someone on my side.

***** 5 stars based on 202 reviews

Speak With An Attorney Now

Request a free legal consultation: Call 800-682-8331 or Email Us