Disability Insurer Profiles: Hartford

The Hartford (“Hartford”) insurance company can reasonably be considered one of the oldest and largest insurance companies. Hartford was founded over two-hundred years ago and has acquired myriad assets valued at around $225 billion in 2017.[1]

If you have a Hartford policy, you should be aware that Hartford (like most other insurance companies) will likely review and investigate your claim at multiple times throughout the claim—particularly if you have a policy that shifts from “own occupation” to “any occupation” after a certain time frame.

Hartford has also shown that it will go to great lengths to defend claim terminations. For example, in Post v. Hartford[2], a dentist, who also worked as a pharmacist, filed a disability claim after she suffered traumatic cervical and lumbar strain as a result of a car accident. She made an attempt to go back to work following the accident, but eventually the neck pain and lumbar radiculopathy became so bad that she could no longer continue working.

Hartford initially paid the claim, but after a few years had passed, Hartford terminated the dentist’s benefits. Prior to terminating the claim, Hartford conducted surveillance of the dentist’s home, sought to obtain the dentist’s tax returns from prior years, attempted to schedule a functional capacity evaluation (FCE), and hired a doctor to conduct a file review of the dentist’s medical records. Hartford based its decision to terminate the claim on the medical record, its consultant doctor’s report, and its claim that the dentist refused to undergo the FCE.

The dentist appealed the denial and disagreed with Hartford’s position that she had refused to undergo an FCE. The dentist’s treating physician also sent a letter to Harford stating that the dentist suffered from myofascial pain syndrome, chronic fatigue syndrome and chronic headaches and was on narcotic medications. The treating physician also advised that the dentist should not undergo an FCE, as that would exacerbate her symptoms. Hartford gave no weight to this letter, and upheld its termination.

The dentist and her attorney then sued Hartford, and the parties agreed to dismiss the case, agreeing that Hartford would reconsider the dentist’s claim if the dentist underwent an independent medical exam (IME). Following the IME, the IME doctor’s report stated that the dentist’s complaints were solely subjective, and Harford again upheld its termination.

Next, the dentist sued Hartford (for a second time), and the court upheld Hartford’s denial. The dentist appealed the decision, and the appellate court partially vacated the lower court decision, noting several concerns about how Hartford had handled the claim, including:

    • “Hartford’s attempt to use Post’s Social Security benefits to offset her disability benefits, despite the plan not allowing for such an offset”;
    • The fact that “Post had not refused the FCE, but that Hartford was quick to conclude that she had, despite never making a written request for her to undergo a FCE”;
    • The fact that “Hartford did not allow Post to see [the IME report] before making its final decision to terminate,” giving the dentist “no opportunity to allow her treating physicians to comment on it”;
    • The fact that Hartford’s decision to terminate relied heavily on [its consulting doctor’s] report, which was not based on a physical examination”;
    • Hartford’s “aggressive tactic” of pursuing the dentist’s tax returns “in the face of ambiguous Plan language”; and
    • The fact that “Hartford continued to investigate her claim despite using surveillance which revealed that she did not leave her home.”

The Court also observed that the surveillance Hartford obtained was “consistent with, and corroborative of her claim of disability” and concluded that “the very fact that [Hartford’s] employees characterized the results of the surveillance as ‘unsuccessful’ suggests that its motive was to find evidence to deny Post’s claim.”

The appellate court sent the case back to the lower court for further proceedings, and the lower court held in favor of the dentist and overturned Hartford’s denial of benefits. Although the denial was ultimately overturned, it took over six years from the date of the initial benefit termination and multiple lawsuits to get Hartford to pay the dentist her benefits.

These are just a few examples of things to be aware of if you have a Hartford policy or claim with Hartford. Hartford policies are not all identical, and they are updated frequently. Your policy may or may not include the provisions mentioned above. If you are considering filing a disability claim, you should consult with an experienced disability insurance attorney to learn more about your policy and any potential issues related to your particular claim.

[1] https://ir.thehartford.com/~/media/Files/T/Thehartford-IR/documents/annual-reports-and-proxy-statements/2017-annual-report.pdf.

[2] Post v. Hartford Ins. Co., No. CIV.A. 04-3230, 2008 WL 4444240, at *3 (E.D. Pa. Oct. 2, 2008).

 

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