Prudential Disability Claims Lawyer

Experienced Prudential Disability Claims Lawyer

Prudential Financial Company is a holding company that offers a variety of financial and insurance products to both individuals and businesses. This includes life insurance, short and long-term group disability insurance coverage, accidental death, dismemberment policy, and other types of insurance coverage. Although there are many exemplar insurance carriers, Prudential is a classic example of an insurance company that isn’t really in the insurance business. It has its hands in securities, investments, residential real estate, home mortgages, the corporate relocation business, and, oh yes, employee benefits.

It has always “searched for a way to maximize income from its investments” according to Wiki, and its claims handling methods, as illustrated in real life Prudential policyholder stories,  are a prime example of maximizing income. But, that income comes at the expense of its policyholders. Prudential has been the subject of insurance regulators investigations in 1996, which resulted in a settlement of the claim that they had been “churning” which is a process in which agents generate commissions by inducing policyholders to trade up to more expensive policies.

All too often, Prudential rips the financial rug and safety net from under its disability insurance policyholders.

Common Tactics Used By Prudential

Prudential will:

• Use surveillance to discredit the policyholder’s complaints,
• Use in-house nurses to review medical records and reach medical conclusions about the policy-holders restrictions and limitations even though those nurses may have no training in or qualifications to render any opinions about the policyholder’s medical conditions,
• Use in-house vocational evaluators to misclassify the policy holder’s occupation, perform questionable transferrable skills analysis and misinterpret the wages of and availability of other occupations it will claim the policyholder can do to justify the denial or termination of benefits.
• Use biased medical peer review providers to create medical justifications for a claim’s denial,

Courts across the United States have criticized Prudential claims handling.

Prudential is known to make endless and multiple requests for medical, financial, and vocational information before it figures out a way to deny benefits. This delay and denial strategy drains the policy holder’s bank accounts as they try to stay financially afloat. They also rarely tell a denied policyholder the real reasons the claim was denied. You need an experienced lawyer, like myself, who battles Prudential daily.

How A Disability Claims Attorney Can Help You

Nancy Cavey can help you with your Prudential claim by:

• Reviewing your medical records,
• Reviewing your policy,
• Create a pre-claim strategy to get your benefits on the initial application,
• Appeal a wrongful denial or termination by writing an appeal letter 25 to 60 pages long that is the trial of your case and goes to Prudential in a box,
• Protect you from aggressive claims handling by Prudential, including the delay game, we need more information game, we want to take your statement game or we want to have you under an independent medical examination or FCE,
• Aggressively litigating your case, if need be.

Prudential plays games with all initial applications and makes endless and multiple requests for medical, financial, and vocational information before it figures out a way to deny benefits. This denial and delay strategy drains the policyholder’s bank accounts as they try to stay financially afloat. It is how they do business.

Prudential uses their preferred doctors who give them the ammunition it needs to justify a claim’s denial or termination. Prudential hardly ever tells a denied policyholder the real reasons the claim was denied. An experienced disability lawyer who battles Prudential daily will give you the help you need.

Let me tell you the awful story of Mr. Burrell and the infamous “liar for hire” trio of Dr. Alan Neuren, Dr. James Boone, and Dr. Michael Chafetz.

Burell V. Prudential Insurance Company

The case of Burell v. Prudential Insurance Company, 820 F.3d 132 (5^th Cir. April 11, 2016) is an affront to the multiple sclerosis (MS) community and a testament of the lengths to which Prudential will go to deny a claim.https://caselaw.findlaw.com/us-5th-circuit/1731664.html

Mr. Burrell was the Director of Biomedical Services for Methodist Healthcare Systems in San Antonio. He was diagnosed with MS and stopped working because of his MS symptoms, headaches, depression, and anxiety. He filed a claim and Prudential had the file reviewed by Dr. Alan Neuren, a neurologist, who in my opinion had seemingly never reviewed a case that had a supported diagnosis of any condition, including MS, and opined that job stress was the cause of any cognitive symptoms. Just Google the good Dr. Neuren. I keep a case bank on Neuren so my appeal letters are blanked with all the decisions in which the courts have rejected his canned and biased opinions.

On appeal, Prudential pulled out its neuropsychological gun, Dr. James Boone. Of course, Boone said what he always says, “file records do not validly support psychological and/or cognitive symptoms.”  I have pages of material on Boone, including some interesting depositions that clearly reveal, in my opinion,  his bias. The denial was upheld and Burell appealed again. Yet, again Prudential used Dr. Michael Chafetz, a neuropsychologist, who is in my opinion, another disability carrier player.

All of these doctors are frequent flyers and they are used to create the appearance of a fair review. Just change the name of the policyholder and these three seem to reach the same carrier-favorable opinions.

Unfortunately, this charade fooled the court who bought the whole Prudential story and who conveniently ignored the favorable Social Security disability opinion.

Our Prudential Disability Claims Lawyer Is Here To Help

Some Prudential policyholders make the mistake of going it alone and pay dearly for “doing it yourself.” This route is very challenging and frustrating.

Once the appeals process is exhausted (and that really means you are exhausted by the endless requests for information and battling with Prudential), the only recourse is to file a lawsuit. If you purchased your insurance through your employer, the policy is most likely governed by the Employee Retirement Security Act or ERISA.

The ERISA statute and regulations are NOT policyholder friendly.  You CANNOT add anything to the claims file after the last denial so all the Federal judge gets to see is what is in Prudential’s file which is stuffed with medical and vocational opinions that are favorable to Prudential. You didn’t know enough to add medical, vocational, or lay evidence to the file. You didn’t know enough to get the claims file when you appealed or didn’t make the right arguments. Your case is all but destroyed.

An appeal of a denied Prudential claim is the trial of your case. Taking on a tough insurance company like Prudential is an endeavor for a specialist. Unfortunately, a federal judge will give Prudential the benefit of the doubt because your Prudential policy requires you to prove they are wrong. It is in the best interest of yourself and your family to have an experienced disability lawyer, like Nancy Cavey, take on Prudential. This is all about getting the disability benefits you deserve and you paid for.

Some policyholders have bought their own disability policy through an agent and that is known as an individual disability insurance policy. The game is the same but the playing field is more level because any claims denial can be challenged in state court which is a friendlier place to be if you have to sue Prudential.

Don’t think that Prudential isn’t playing the claims delay, denial, or termination game with individual disability policies. They are, and the policy benefits at stake are high. There is much more to lose if you aren’t represented by a Prudential individual disability attorney like me.

Prudential’s Disability Policies:

The type of policy that you have will determine your rights and whether you are playing on a level playing field.

ERISA Group Disability Insurance

Prudential offers disability policies through employers which are governed by ERISA. A Prudential ERISA policy generally has the following:

• strict definitions of disability and occupation,
• limitations on how long payment will be made for mental conditions or subjective conditions like  headaches, pain, fibromyalgia or chronic fatigue,
• “other income” provisions that allow for a dollar for dollar reduction for the receipt of Social Security disability benefits, workers’ compensation benefits, and personal injury settlements, and
• A “golden handcuff” on a judge that only allows for a claims denial or termination reversal if Prudential’s decision is “arbitrary and capricious.”

Non-ERISA Group Disability Insurance

However, a group plan offered by a church plan, such as the Catholic Church, or by a municipal employer like the City of Baltimore, Baltimore County, or the State of Maryland is NOT generally covered by ERISA. The policy terms are much like those of an ERISA plan but there is one CRUCIAL difference. A claim’s denial or termination can be challenged in state court and new evidence can be submitted at trial.

State law courts are a much friendlier place for a policyholder than Federal court. You are entitled to a jury trial in a state law claim and not some Federal judge just making a decision based on Prudential’s file stuffed full of things that are unfavorable for you!

Disability (ID) Insurance for Individuals

Without a doubt, the best and most expensive policy is a private individual disability policy known as an ID policy. The policy terms and coverage are broader and more generous. But that means a high monthly premium and a lot of financial exposure that Prudential has if you become disabled.

It isn’t uncommon for Prudential to invoke a pre-existing exclusion or a medical condition policy rider right out of the box as a way to justify a denial of the claim from the beginning of the claim. That is just one reason why it is so important for a policyholder to contact me BEFORE they stop working and apply for benefits. They will fight an individual disability claim as hard, if not harder than an ERISA claim and costly mistakes can be made at the initial application and appeal stages of a case.

Prudential Disability Faqs

Here are some frequently asked questions about Prudential Disability Claims.

How Long Does Prudential Long-Term Disability Last?

The loss of a paycheck can put a serious financial strain on an employee and their loved ones. Long-term disability insurance provides much-needed paycheck protection. Through a major insurance company such as Prudential, you can seek benefits for covered injuries, illnesses, and medical conditions.

You may be wondering how long insurance benefits will last. The answer depends on the terms of your policy. Prudential offers a wide range of long-term disability plans. Though, the company notes that many of its policies provide benefits until the employee can return to the workplace or until their normal retirement age. If you have any questions about the duration of long-term disability benefits, contact an experienced Prudential insurance claims attorney for help.

How Does Long-Term Disability Work With Prudential?

Prudential’s long-term disability coverage works similar to the insurance coverage offered by other large companies. The purpose of long-term disability insurance is to provide partial income replacement to employees who are unable to work for extended periods of time due to an injury or illness.

In most cases, people obtain a group disability plan through an employer. These ERISA regulated insurance policies are generally more cost-effective because an employer is in a position to get a better rate. ERISA is a complex federal law that standardized the disability claims process. Unfortunately, in some ways, ERISA stacks the cards in favor of large insurance companies.

The key issue is determining if and when you are eligible for benefits. Do not assume that you are unable to apply. If you or your loved one cannot work on a full-time basis, you should explore every option for financial support.
To obtain long term disability benefits through Prudential, a claimant should submit an employee statement, employer statement, a physician’s statement. Together, these documents help to confirm medical and vocational eligibility. If you are struggling to get your long term disability claim paid in full, a top-rated Prudential insurance claims lawyer can help.

How To Calculate Short-Term Disability With Prudential

Prudential offers short-term disability insurance policies to both groups and individuals. Through these policies, a temporarily disabled employee can access a much-needed source of income. Short-term disability benefits typically have a maximum duration of three months, six months, or one year. Though, benefits will always end if the worker is able to return to their position because their injury/illness has improved.

The amount of a short-term disability benefit will depend on an employee’s pre-disability earnings and their specific type of insurance coverage. As a general matter, these benefits are paid at 40 percent, 50 percent, 60 percent, or 70 percent of an applicant’s pre-injury or pre-illness wages. All of the company’s short-term disability policies are subject to maximum weekly benefits, which can be as low as $500 per week. If you have any specific questions about how Prudential calculates short-term disability benefits, our Florida law firm is available to help.

Hire An Experienced Prudential Disability Claims Lawyer

Disability Attorney Nancy Cavey practices disability insurance law throughout the United States, she receives many Prudential Disability Insurance inquires about the disability insurance claims process. She represents Prudential disability insurance policyholders who have submitted disability claims which have been either delayed, disputed, or denied. If you are a Prudential Disability Insurance policyholder in need of assistance, contact The Law Office of Nancy L. Cavey today.