Understand your rights once your Hartford short term disability income claim has been denied. In this featured article and video gain insights into:
- Hartford Deadlines
- Administrative Appeal – What Is It?
- Administrative Appeal Process
- Benefits of Hiring A Disability Insurance Attorney
[00:00:04.74] GREGORY DELL: Hi. I’m attorney Greg Dell, here with Stephen. And we’re going to talk about what happens if my Hartford short term disability claim is denied. Steve, this is probably what we get tons of calls for every single day. It’s an ERISA group, long term or short term disability policy. The benefits have unexpectedly been denied. What does a claimant need to do?
[00:00:28.27] STEPHEN JESSUP: No matter if it’s short or long term, in that denial letter, they’re going to explain what your rights are, that you’re going to have 180 days to file an appeal. They’ll have 45 days to review it. They usually don’t let the person know that there may be an extension to that review. But you at that point, at the denial, have the right to go through an administrative appeal process.
What Is the Administrative Appeal Process?
[00:00:45.49] GREGORY DELL: And what is an administrative appeal process? Does that mean immediately you have to hire a lawyer and go to court?
[00:00:52.18] STEPHEN JESSUP: No. No. You’re not going to go to court first. So under ERISA, the statute that’s going to govern these policies, it mandates that you have at least one level of mandatory administrative review. So you submit an appeal back to Hartford. It goes to an appeals department, someone who’s never looked at your case, new medical reviews. And they have a fresh set of eyes to determine if the people who initially denied the case made the right decision. Obviously, there is a conflict of interest. Hartford’s already denied you. Now you’re relying on other people at Hartford to say their colleagues were wrong.
[00:01:25.15] GREGORY DELL: So we have done videos, which I encourage our viewers to watch, as tips for a successful Hartford appeal. You mentioned that somebody can do — you don’t have to have a lawyer —
[00:01:36.82] STEPHEN JESSUP: Correct.
What Is at Stake If a Hartford Appeal Is Not Done Correctly?
[00:01:37.13] GREGORY DELL: — to do an appeal. Why is it advantageous, though, for someone to have a lawyer when doing this appeal? What’s at stake if it’s not done correctly?
[00:01:44.95] STEPHEN JESSUP: Well, what’s at stake is your benefits. We’ve seen plenty of times where people do their own appeal. It’s not to say you can’t win it.
[00:01:52.66] But the importance of an appeal, which Hartford will never tell you, is you get one shot at it. If they deny that appeal, your claim trial closes. The record closes. Which means when you have to file a lawsuit at that point, no new information is allowed to come in for a judge to consider.
[00:02:08.89] We’ve talked in videos about you know litigating these things. But to give you the importance of what to do with the appeal itself, there are no jury trials. You don’t testify. Your doctors don’t testify. A lot of times, the judges don’t even want to hear from the attorneys. They just want motions.
[00:02:22.96] And that judge is only going to look at you or your administrative record, which is your claim file. That’s what Hartford created in reviewing and what you submitted in it. And as a standard default, the way a judge looks at is a 2-step process.
[00:02:35.69] One, they determine is there enough information you’re disabled. If yes, it goes to a second one. Did Hartford act arbitrary and capricious? Or did they have a reasonable basis to deny a claim?
[00:02:46.10] So it puts a court in a position where they could think that Hartford got the wrong answer. But they weren’t unreasonable in their actual outcome. So if you don’t submit everything you’re going to need in your appeal, you’re going to be forever barred from doing it. And it’s only going to increase the likelihood of losing in court. So your appeal, even though it seems benign and this denial letter, no. Just write us a letter why you disagree and that you want to appeal it really is the most important aspect of your claim going forward.
[00:03:16.76] GREGORY DELL: A lot of times, Hartford’s notorious for telling the claimant, just go ahead and write us a letter as to why you disagree. And I want people to understand that’s the single worst thing that they could do. Because if you don’t write a very, very strong appeal, first of all, the likelihood that you’re going to win the appeal is next to none.
Filing a Disability Insurance Lawsuit with the Hartford
[00:03:34.54] And then with a very poor appeal, if you then decide to hire a lawyer after that, which the only remaining remedy is to file a lawsuit, you’re going to have almost no chance of winning that lawsuit because the judge ends up reviewing the appeal basically. I mean, yes, he’ll look at the underlying claim. But then he’s really looking at what was submitted on the appeal to see the type of review that was done and what additional information the claimant submitted.
[00:03:57.41] And if they don’t submit anything good, then it’s going to be almost impossible. So easy solution for people out there who have been denied and are trying to figure out what to do is give us a call. Any of our lawyers will immediately review your denial letter. No matter where you live, we’re going to provide you with an immediate free phone consultation.
[00:04:15.40] And it’s a very simple process. We’ll be on the phone with you for as long as it takes to explain to you your current situation. We don’t charge you any fees or costs unless we win your appeal. So there’s really no risk whatsoever for you to work with us. And we appreciate you considering our law firm.
Hartford policyholders who need to file an appeal after Hartford has denied your disability income benefits can reach out to the disability insurance attorneys at the Dell & Schaefer. We help claimants nationwide and we always provide a FREE initial consultation of Hartford claim denials.