Hartford Buys Out Disability Policy Following Appeal
Author: Attorney Stephen Jessup
When our client first contacted our Office he was unsure if he even had a case worth pursuing. After being on long term disability for a year, and still within his “Own Occupation” period Hartford denied his claim for continued benefits based on video surveillance conducted, an in-person interview, and the results of an Independent Medical Examination they had sent him to. By all accounts, prior to denying the claim, Hartford had performed a thorough review of the claim. The loss of monthly benefits and the financial hardship that resulted on account of it was made even worse due to the fact Hartford was also threatening to send him to a collection agency to recover an overpayment on his claim. If this wasn’t bad enough, prior to contacting Attorneys Dell & Schaefer he had legal representation that dropped our client’s case a few weeks before the administrative appeal was due to Hartford, as the attorney had felt there was not a reasonable chance of securing benefits. Despite all of this, Attorney Stephen Jessup resolved to assist our client in securing from Hartford what was rightfully his.
Our client’s Hartford policy contained a “discretionary clause” that would potentially require a Judge to give deference to Hartford’s decision to deny the claim should the case have to go to trial. Without a doubt, Hartford had certainly did enough in reviewing our client’s claim prior to denial to prove to a Judge that it had acted reasonable when determining our client was no longer entitled to continued benefits. Realizing this Attorney Jessup’s first and most immediate order of business was securing an extension to file our client’s appeal as it would take some time to compile additional evidence to strengthen our client’s claim and not only give him client the best reasonable chance of winning his Appeal but also to give him the best chance of prevailing at trial.
Hartford granted a brief extension to file the appeal. During this time Attorney Jessup secured a copy of the Claim File and set to work to review and find any discrepancies and inconsistencies to undermine the volume of information Hartford created and compiled to deny the claim. Attorney Jessup arranged for our client to undergo an independent Functional Capacity Evaluation and coordinated with our client’s doctors to prepare responses to Hartford’s Independent Medical Examiner’s report. Additionally, as Hartford had denied our client’s claim during the “Own Occupation” period Attorney Jessup also focused his attention to ensuring that Hartford would not simply overturn its denial as it related to our client’s inability to perform his Own Occupation and then deny for any additional benefits under the “Any Occupation” definition of disability.
When all of the information was gathered Attorney Jessup submitted our client’s Appeal. Despite all of the steps Hartford had taken to deny the claim Attorney Jessup was successful in forcing Hartford to overturn its initial denial.
Overpayment and Buy Out
After the denial of benefits was overturned Attorney Jessup was then able to prevent our client’s overpayment from being referred to collections and negotiated a repayment plan with Hartford. During this time Attorney Jessup also worked to ensure and secure benefits for our client into the Any Occupation period. After successfully navigating all the obstacles that had plagued our client’s claim Attorney Jessup was able to negotiate with Hartford to secure a lump sum settlement of our client’s claim for benefits.
In less than a year our client went from feeling hopeless and abandoned when his claim was denied to constantly worried about whether Hartford would arbitrarily deny his claim again, and now to being secure in knowing his income is protected and he will no longer be at the mercy of Hartford.