Reliance Standard Overturns Denial of LTD Disability Benefits to Timeshare Salesman

Our client, a successful Timeshare Salesman on the island of Hawaii, had a long history of battling with ongoing chronic pain as a result of cervical disc herniations with nerve impingement and radiculopathy, in addition to thoracic and lumbar disc herniations. Needless to say his pain affected not only his ability to work, but also all other facets of his life. Unable to continue to work in light of his ongoing symptoms, our client filed a claim for short-term disability benefits under his employer’s policy with Reliance Standard, which was approved for the maximum 6 month period. From there his claim was transitioned to long term disability benefits. Again, Reliance Standard approved his claim for disability benefits. Our client thought his claim was “in the clear.” However, review of the claim file following the denial of his benefits indicated that shortly after his long term disability benefits were approved, Reliance Standard was already investigating the claim to find ways to deny benefits.

The Denial of Disability Benefits By Reliance

Less than 1 year after his long term disability claim was approved, and still during the “own occupation” period, Reliance Standard was conducting a full blown review of our client’s entitlement to continued benefits. This review included an Independent Medical Examination; an internal medical review with two doctors; video surveillance; and extensive research on the internet, which noted that our client had been doing extensive blogging on an almost daily basis. Although it would ultimately be determined that Reliance Standard took multiple liberties with interpreting the information it compiled (to include cherry picking the report of its own IME doctor) Reliance Standard terminated our client’s claim for LTD benefits.

The ERISA Long Term Disability Appeal

Our client contacted Dell Disability Lawyers with a little over a month before his appeal was due. Attorney Stephen Jessup worked quickly to secure a copy of the claim file and requested a short extension of time with which to file the appeal to ensure that all of the medical records and information necessary for the appeal to have a chance of success could be obtained. Reliance Standard unequivocally denied the request for an extension. With no time to waste Attorney Jessup set out to undermine the basis of the information used by Reliance Standard in denying the claim – a feat that seemed daunting given the extent of Reliance Standard’s review of our client’s claim and the blogging information it obtained from the internet that shed a dark shadow on the claim.

Video Surveillance

Review of the claim file indicated that video surveillance had been performed during the course of the review. From experience, Attorney Jessup knew that the failure of an insurance company to refer to video surveillance in a denial letter was most often indicative of the surveillance finding nothing noteworthy – as was the case with our client. For two days his home was staked out, and not once was he observed. Attorney Jessup used this as evidence of his severe restrictions and limitations and the role his pain played in affecting all aspects of his life.

IME

In the overwhelming number of ERISA disability claim denials, the insurance company does not subject the claimant to a physical independent medical examination, and instead relies on file reviews completed by either external or internal doctors. The reasons for requesting an IME are multiple, but in this case the overriding factors in our client’s claim were his age, benefit amount and his internet presence. Reliance Standard was trying to ensure that its review would not be deemed “arbitrary and capricious” by a court should the case go to trial.

There was only one problem with Reliance Standard’s plan – the IME doctor was actually supportive of our client’s claim in multiple ways and had provided suggested restrictions and limitations to our client’s physical ability to work. However, Reliance Standard, in a move usually reserved for an insured’s own medical records, cherry picked the information from the IME report that would support its agenda and discarded the rest. Attorney Jessup was quick to pounce on this and drive this fact to the forefront of the appeal.

Internet Blogging

Perhaps some of the most harmful evidence against our client was the extensive amount of blogging he performed on a near daily basis. Reliance Standard used this as a basis to argue that he would not only be able to work a full time sedentary job but also that the side effects of his medication were not impairing his cognitive ability. Reviewing the frequency of posts and discussing the blogging with our client, Attorney Jessup was able to minimize the impact of the blogging, noting that our client was able to blog at his leisure, take frequent breaks, did not have to worry about completing an entry, and that it was merely a way for him to stay mentally active. In the appeal, Attorney Jessup was able to differentiate the ability to blog as a hobby as opposed to the real life requirements of deadlines and work product required in a job setting.

The Counter Attack

Knowing there were several obstacles to overcome in the appeal, Attorney Jessup quickly set out to arrange for functional capacity testing to be performed in hopes of obtaining additional objective evidence of our client’s inability to perform even sedentary level work. The results of the test would be vital, as there was not enough time before the appeal was due to have updated MRIs performed to document and substantiate our client’s assertions that his pain had increased significantly since the inception of his claim. Attorney Jessup also reached out to our client’s treating physicians to obtain all relevant medical information and to provide additional statements and questionnaires tailored to counter the reasons and rationale of Reliance Standard’s denial of benefits. With the deadline to file the Appeal expiring, Attorney Jessup filed the administrative appeal, which contained as much argument as to Reliance Standard’s improper denial of benefits as updated medical records. Faced with the information presented in the appeal, prior to the expiration of the 45 day deadline to provide a response, Reliance Standard overturned its denial, reinstated our client’s benefits and forward a check for all back benefits owed.

Has your long term disability insurance claim been denied?

The most important take away from our client’s situation is the fact that insurance companies are constantly searching the internet and social media sites for information on their insured. We have seen on numerous occasions instances of an insurance company using information obtained from a Facebook, LinkedIn, Blog, Twitter, Instagram, etc. account as a factor in denying a claim for benefits. A disability insurance claimant must realize that information they put on the internet can and will be used against them by their insurance company. As such it is very important to make sure that if you are going to post anything to the internet that your privacy settings for the respective media are set so that the general public cannot view your information. Realize that the internet is the new “video surveillance.”

If your claim is being challenged by your insurance company, has been denied, or you are concerned that your carrier is investigating you, please feel free to contact Dell Disability Lawyers for a free consultation.


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Reliance Standard Reviews
(47)

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Showing 8 of 47 Reviews
Reliance Standard

Reliance Standard denied my LTD benefits because COVID-19 limited my ability to provide proof of continued disability.

Reviewed by Ken S. on February 11th 2021   Verified Policyholder
Hello, I have a LTD policy with Reliance Standard and it has been paid (considered disabled) for 14 plus years. However, due to limited doctors visits / records this past ... read more >
Reply
Sent on February 11th 2021 by Attorney Cesar Gavidia

Ken, it’s important to ensure that if your claim is denied your Appeal be exhaustive, comprehensive, and contain not only all of your relevant medical records, but th... read more >

Reliance Standard

Reliance Standard cut off my LTD benefits claiming I'm fit enough to work even though I'm more sick than before.

Reviewed by Jeff S. on July 7th 2020   Verified Policyholder
It should be criminal that this company treats sick people like this who just want PTO be left alone! I received a call from Reliance on 7/6/20 cutting me off after 1 year... read more >
Reply
Sent on July 7th 2020 by Attorney Stephen Jessup

Jeff, in my opinion Reliance Standard is one of the more difficult insurance companies to deal with. What you are experiencing they do day in, day out. You can certainl... read more >

Reliance Standard

Reliance Standard notified me that my benefits were being stopped with no warning or reason.

Reviewed by Deborah S. on June 5th 2020   Verified Policyholder
Horrible company! Phoned me on June 4th to let me know that I would no longer be receiving benefits as of June 3rd. Just like that! No questions asked and no info given!
Reply
Sent on June 5th 2020 by Attorney Gregory Dell

Deborah, I am sorry to hear of the denial of your claim and how you were provided no notice of an immediate end of your income. Please contact us at once for a free con... read more >

Reliance Standard

I was receiving LTD from Reliance Standard due to breast cancer until they suddenly denied me my benefits.

Reviewed by Mary Anne B. on March 3rd 2020   Verified Policyholder
I was diagnosed stage 2 breast cancer June 2015 and went out on std with Reliance. Within 4 months following my status changed to stage 4 with Mets to my spine. STD conver... read more >
Reply
Sent on March 3rd 2020 by Attorney Stephen Jessup

Mary Anne, your recourse would be to go through the administrative appeal process and if that is denied to file lawsuit. Please contact our office to discuss the denial... read more >

Reliance Standard

Reliance Standard never answers or returns my calls, has not provided me my benefits, and falsely claims I never provided necessary paperwork.

Reviewed by Chrystall on July 5th 2017   Verified Policyholder
I have been on STDI since April 28th, 2017 and I have only received what they say is a “courtesy payment” because they know the hardship which I am facing. I call mult... read more >
Reply
Sent on July 5th 2017 by Attorney Stephen Jessup

Chrystall, please feel free to contact our office to discuss your claim. Needless to say, the carrier is well beyond the typical timeframe to render a decision on a STD... read more >

Reliance Standard

Reliance Standard is unreasonably prolonging the transition from STD to LTD for my boyfriend.

Reviewed by Wendy on April 4th 2017   Verified Policyholder
In August 2016 my boyfriend was placed on disability by his family physician. A short background, he is a type I Diabetic since age 4 and had to have multiple lumbar back ... read more >
Reply
Sent on April 4th 2017 by Attorney Stephen Jessup

Wendy, please contact our office to discuss the claim further. Decisions on long term disability claim applications should only take about 45-60 days. If the claim is d... read more >

Reliance Standard

The appeals process with Reliance Standard is very frustrating. I'm not sure how to get an answer from them.

Reviewed by Rachel on October 23rd 2016   Verified Policyholder
I started with Reliance Standard when i had surgery 4/13, complications in surgery caused my recover last longer and brought my Lupus out of remission. I stayed on STD wit... read more >
Reply
Sent on October 23rd 2016 by Attorney Stephen Jessup

Rachel, if your claim was denied and your appeal already submitted there may be little that can be done until such time that RSL renders a decision on your appeal, whic... read more >

Reliance Standard

Reliance Standard is trying to reduce my LTD benefits because of once-a-month work in the military reserve.

Reviewed by Drake on May 23rd 2016   Verified Policyholder
I have had LTD with Reliance Standard since 2006. I had to jump through all the required social security applications until I was lucky approved after 2 denials by an Admi... read more >
Reply
Sent on May 23rd 2016 by Attorney Stephen Jessup

Drake, please feel free to contact our office to discuss. Have they sent any correspondence regarding same?

Answered Questions by Our Lawyers
(23)
Showing 8 of 23 Answered Questions

Q: Will Reliance Standard reduce my LTD payments due to my pension benefits or rental income?

Answered on November 3rd 2022 by Attorney Alex Palamara
A: ARH, I am happy to hear of your LTD approval, though I am sorry to hear of your medical conditions. The LTD po... Read More >

Q: Why is Reliance Standard trying to recover payments I was awarded through another company?

Answered on August 6th 2020 by Attorney Cesar Gavidia
A: Dani, your disability plan may contain a provision which allows Reliance to claim and recover an overpayment o... Read More >

Q: Do I have to provide additional proof of my disability that's specifically requested by Reliance Standard?

Answered on July 11th 2020 by Attorney Alex Palamara
A: Fred, I am sorry to hear all that you have been through medically and in dealing with Reliance Standard. Unfor... Read More >

Q: How do I access a copy of my STD policy with Reliance Standard?

Answered on March 26th 2019 by Attorney Alex Palamara
A: Vicki, I am sorry to hear the trouble you are having with the Standard. It seems they are certainly make thing... Read More >

Q: If I'm not receiving the SSDI benefits for my children from Reliance Standard due to custody, should my SSDI benefits increase?

Answered on July 11th 2018 by Attorney Cesar Gavidia
A: Bill, it depends on terms and conditions relating to “other income benefits” and “offset” under your f... Read More >

Q: How can Reliance Standard not coordinate with both of my disability insurance policies?

Answered on December 13th 2017 by Attorney Stephen Jessup
A: Jerry, you will need to review your RSL policy to determine what it deems to be a source of “Other Income”... Read More >

Q: How can I get Reliance Standard to pay me the full amount of my withheld SSDI benefits?

Answered on April 25th 2017 by Attorney Stephen Jessup
A: Ej, typically RSL will only withhold funds if SSDI has not been applied for. My recommendation at this point w... Read More >

Q: My child is over 18 and directly received part of my payment from my SSD benefits, can Reliance Standard claim that as part of the overpayment?

Answered on November 21st 2016 by Attorney Stephen Jessup
A: Cyndi, RSL would have a right to recoup the DSSDI amounts. How long ago was your LTD claim closed? Did you go ... Read More >
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Dell Disability Cases
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Reliance Standard overturned its previous denial of long term disability benefits for Texas Retail Store Manager

Our client, Mr. S, formerly worked as a Store Manager for a large national retail chain. In August 2016 Mr. S suffered from multiple Transient... Read More >

Reliance Standard overturned LTD denial for Tennessee Technology Sales Consultant

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After sending claimant to a psychiatric IME, Reliance Standard realizes its decision to deny benefits was incorrect

Reliance Standard Incorrectly Denies BenefitsThe claimant had been suffering from severe depression and anxiety due to many stressors in h... Read More >

Reliance Standard Admits They Were Wrong in Denying Long Term Disability Benefits

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Reliance Standard Wrongfully Denies Life Insurance Waiver of Premium and Must Pay $188,000

In Jody Rizzo v. First Reliance Standard Life Insurance Company, plaintiff’s late husband, Angelo Rizzo, participated in a group l... Read More >

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In Tiedel v. Reliance Standard life Insurance Company (Reliance), Plaintiff Tiedel, a full-time flight engineer for K... Read More >

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In the case of Cheryl L. Wallace v. Oakwood Healthcare, Inc. (Oakwood), Plaintiff was employed by Oakwood Healthcare, Inc. Health Sy... Read More >

Court Upholds Reliance’s Denial of Disability Benefits to Riverboat Pilot

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In Karen Gammon v. Reliance Standard Life Insurance Company (Reliance), Plaintiff worked for Cape Cod Hospital for 23 years as a med... Read More >

District Court Holds That Reliance Standard Did Not Properly Consider Whether Traveling Nurse Could Perform The Material Duties Of Her Regular Occupation

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