Hartford Life Faces Denied Disability Lawsuit

San Francisco, CAHartford Life faces a lawsuit alleging the company wrongfully denied a disability insurance claim. The lawsuit was filed in June 2016 under the Employee Retirement Income Security Act (ERISA), and alleges the plaintiff’s insurance claim was denied without proper reasons given.

According to the Northern California Record (6/23/16), Linda Kachalkin filed the lawsuit (case number 4:16-cv-03434, US District Court, Northern District of California) alleging violations of ERISA. After allegedly being found disabled on August 22, 2014, Kachalkin filed a claim for benefits, but in November 2014, her claim was denied. Kachalkin’s lawsuit seeks reinstatement of benefits.

Various insurance companies face lawsuits alleging they have wrongfully denied policyholders’ benefits or committed other bad faith insurance practices. Some companies have even faced sanctions from officials for mistreatment of policyholders. Among tactics allegedly used by insurance companies are relying on the opinion of their own doctors over the policyholders’ doctors - even in cases where the insurance company’s doctors never actually see the patient in person - deeming medically accepted treatments as “experimental” and refusing to cover such treatment, or requiring patients to become sicker before their insurance benefits cover treatment (such as with hepatitis C cases).

In cases where the insurance policy is covered by ERISA, policyholders must first exhaust their insurance company’s appeals process before filing a lawsuit. This can put claimants in a tough position because they may not realize that the documents they submit as part of their appeal will become the only evidence a judge will review should the claim go to court. Therefore, it’s in the policyholder’s best interests to provide an exhaustive appeals case for why their claim should be allowed.

There are also strict deadlines that must be met when filing appeals, even with the insurance company. Failure to meet those deadlines can result in an appeal being dismissed and a court refusing to hear the claim.

In some cases, class-action lawsuits can be filed against insurance companies, where a large number of people are affected by similar policies or procedures. Recently, Florida Blue Cross agreed to cover Harvoni, a hepatitis C drug, after it faced a proposed class-action lawsuit alleging the company needlessly put patient’s lives at risk by denying coverage for the treatment. Harvoni treatment is reported to have a 95 percent cure rate. The settlement reportedly includes policyholders who are not covered by ERISA, according to Bloomberg BNA (6/23/16).