Hartford attempts to deny store clerk’s claim for disability benefits on the basis of a pre-existing multiple sclerosis condition

McLeod v. Hartford Life and Accident Ins. Co., 372 F.3d 618 (US Court of Appeals Third Circuit 06/22/2004)

On January 26, 1998, Shirley McLeod (hereinafter “McLeod”) was hired by Valley Media to stock video cassettes in its warehouse. Subsequent to her hire date, McLeod signed up for disability insurance under the Valley Media Plan (hereinafter the “Plan”). The Plan’s administrator was Hartford Life and Accident Insurance Company (hereinafter “Hartford”).

Not too long after McLeod started working, she applied for long-term disability benefits. Hartford denied McLeod’s claim for long-term disability benefits on the grounds that her disabling condition, multiple sclerosis, was a pre-existing condition for which long-term disability benefits were not payable under the Plan. Even though McLeod’s diagnosis of multiple sclerosis was not made until August 1999, four months after her effective date of coverage, April 1, 1999, Hartford concluded that McLeod had “received medical [care] for manifestations, symptoms, findings or aggravations relating to or resulting from multiple sclerosis during the 90 day period prior to [her] effective date of coverage. After exhausting her administrative remedies, McLeod sued Hartford, claiming that she had not received treatment for multiple sclerosis during the 90 day look-back period because the multiple sclerosis had not yet been diagnosed at that time. The district court ruled in favor of Hartford and McLeod appealed.

The Third Circuit ultimately reversed the district court’s ruling, holding that “despite language in the benefit plan aimed to cast a broad net as to what constitutes receiving medical care for a ‘pre-existing condition,’ McLeod did not receive treatment for’ such a pre-existing condition prior to her effective date of coverage because neither she nor her physician knew or suspected that the symptoms she was experiencing were in any way connected with multiple sclerosis.” The Court held that McLeod was entitled to receive disability benefits.

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, GoToMeeting.com 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   *****

Leza A.

Extremely professional, knowledgeable, immediately responsive to all my calls and emails, always left comforted that my case is being given all that can be done to accomplish the best results after talking/emailing with Rachel Alters (my attorney) and her team. It has been the best decision I have ever made when I needed the best to help me at such a vulnerable time in my life of having to deal with being so ill and then the realization of the loss of my career that I loved so much, that I had given my all to, and was so successful at.

I can’t thank Dell & Schaefer (Rachel Alters & Team) enough for giving their all for me (my case).

***** 5 stars based on 202 reviews

Speak With An Attorney Now

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