Hartford’s refusal to provide entire claim file did not prejudice claimant’s ability to dispute her denial of disability benefits

Citation: DiGregorio v. Hartford Comprehensive Employee Benefit Serv. Co., No. 04-2219, No. 04-2252, 2005 U.S. App. LEXIS 19380, (1st Cir. Sept. 8, 2005).

Angela DiGregorio, a secretary for Coopers & Lybrand was insured under the company’s group long-term disability plan. In July 1995, carpal tunnel syndrome forced Ms. DiGregorio to stop working and apply for long-term disability benefits with Hartford Comprehensive Employee Benefit Company (hereinafter “Hartford”) who approved Ms. DiGregorio’s claim for benefits. Pursuant to the terms of her disability plan, she was entitled to receive total disability benefits if she was unable to perform the substantial and material duties of her own occupation. After two years, the policy required that in order to be deemed totally disabled Ms. DiGregorio had to show that she was unable to perform any duty pertaining to any occupation for which she was qualified.

During the review of Ms. DiGregorio’s claim file, Hartford found that Ms. DiGregorio no longer satisfied the policy’s definition of disabled and subsequently terminated her benefits. Hartford based its decision on medical records from Ms. DiGregorio’s orthopedic surgeon, an employability analysis and telephone conversations with Ms. DiGregorio.

Following receipt of Hartford’s termination of benefits, Ms. DiGregorio notified Hartford of her intent to appeal and requested a copy of her entire claim file, including reports and documents reviewed by its medical department or outside consultants. In response, Hartford produced the employability analysis and Dr. Howard’s medical records, but did not produce the entire claim file. Despite numerous requests to obtain the entire claim file, Ms. DiGregorio was unsuccessful.

Ms. DiGregorio submitted an appeal of the denial to Hartford and the decision was upheld. Thus, Ms. DiGregorio files a lawsuit against Hartford. Ms. DiGregorio argued that her claim was not given a full and fair review required under the requirements of The Employee Retirement Income Security Act of 1974 (“ERISA”) because Hartford did not disclose the entire claim file to her prior litigation, despite request for same.

The court held that despite Ms. DiGregorio’s inability to obtain her entire claim file, she was not denied a full and fair review because she was unable to show that Hartford’s failure to produce her complete file prevented her from submitting evidence necessary to dispute the denial of her claim for benefits or absence of the entire claim file impacted her ability to prepare an informed response to Hartford’s denial.

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   *****

Zane M.

Since day one I continue to have a very positive experience working with the Dell & Schaefer Law Firm. I am especially grateful to attorney Stephen Jessup who was assigned to my case in early 2010. Steven Jessup and Anneli (Registered Paralegal) are always available and very professional in managing my case in a timely manner. Steven explained the entire (LTD) process to me from day one when I became disabled and unable to work due to my disabilities and had my case approved very quick working with my LTD carrier. My health has worsened since then with a life threatening disease and several surgeries / conditions later. He always answers all of my questions in a timely manner and always has a positive outcome for me. I feel highly represented & grateful with Steve as my LTD attorney which enables me to take care of my health to the best of my abilities without worries.

Steve, I sincerely appreciate all you and Dell & Schaefer have accomplished for me from day one in representing me regarding my case in a very quick and timely manner. I would “most definitely recommend” Attorneys Dell & Schaefer to anyone in dire need of the best in legal representation & counseling in short & long term disability cases.”

God bless to you Steven, Anneli, Greg and all of the Dell & Schaefer Law Firm!

***** 5 stars based on 202 reviews

Speak With An Attorney Now

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