Fight Back Against Unfair Prudential Disability Insurance Denials

Dealing with a disability insurance denial from Prudential can be frustrating and overwhelming. Prudential, one of the largest insurance companies, has faced allegations of violating federal law and wrongfully denying disability insurance benefits. In this article, we will explore the tactics used by insurance companies like Prudential to deny claims and the importance of seeking legal assistance. Robinson Warncke, the nation’s leading disability law firm, is here to help you understand your rights and fight back against Prudential’s unfair practices.

Prudential’s Financial Power and Allegations of Wrongful Denials:

Prudential ranks high on the Fortune 500 list, generating billions in revenue each year. Despite its financial success, Prudential can be aggressive in denying legitimate disability claims. Insurance companies like Prudential often prioritize profits over policyholders’ rights, denying legitimate claims or creating obstacles to discourage claimants. At Robinson Warncke, we are ready to assist you if Prudential has treated you unfairly regarding your disability insurance claim.

The Role of Robinson Warncke:

As the nation’s premier disability law firm, Robinson Warncke has extensive experience handling individual and long-term disability cases. Our team has recovered more than $100 million in unpaid insurance benefits for our clients. We are dedicated to fighting for your rights and ensuring that Prudential does not wrongfully delay or deny your disability insurance benefits. If your claim has been denied or you simply have questions about your claim process, contact us for a free phone consultation.

Understanding Your Prudential Policy:

Prudential’s Long-Term Disability (LTD) Insurance provides income protection in the event of a covered sickness or accidental disability that renders you unable to work. It is crucial to familiarize yourself with the specific features and provisions of your policy to avoid delays and denials. Prudential categorically excludes certain disabilities and causes of injuries. By understanding your policy, you can determine when and if you should challenge a denial.

Exclusions and Definitions in Prudential Policies:

Prudential categorically excludes disability claims caused by intentionally self-inflicted injuries, war, participation in a riot, or criminal convictions. Understanding the definition of disability in your policy is crucial. Prudential typically considers individuals disabled if they are unable to perform the material and substantial duties of their regular occupations. Total disability or a significant loss in monthly earnings, combined with regular care from a treating doctor, are factors Prudential assesses when determining eligibility for benefits.

Recognizing Insurance Bad Faith:

While insurance companies have the right to deny claims that do not meet reasonable conditions of coverage, they also have an obligation to act in good faith. Prudential, like other insurers, must manage claims ethically and lawfully. Acting in bad faith involves unjustified denials, failure to investigate claims properly, unreasonable delays, withholding relevant information, paying less than the policy requires, and improper review of appeals. If you suspect Prudential acted in bad faith, it is essential to seek legal counsel.

Appealing a Denial and Filing Lawsuits:

If Prudential initially denies your claim, you may have the right to appeal. For group disability claims, appealing is generally required before filing a federal lawsuit under ERISA. This is your one and only opportunity to convince Prudential – preferably with compelling new evidence – that your disability is legitimate. It is the most critical phase of every ERISA disability claim.  This is the time during which a specialty law firm can really make a positive difference.

If Prudential has violated certain regulatory duties under ERISA, including missing important decision deadlines, you may be able to file a lawsuit without appealing. This is not a decision to be taken lightly, though, and having expert legal advice is vital. You also have legal obligations you must meet. You also must deal with Prudential fairly and in good faith throughout the process. If you encounter tactics such as endless paperwork requests, delays, or denial due to misrepresentation or pre-existing conditions, seeking legal assistance is vital.

Robinson Warncke’s Expertise and Support:

At Robinson Warncke, we understand the complexities of disability insurance claims and the tactics employed by insurance companies like Prudential. We can evaluate your case, help you explore your options, and take the appropriate legal action. Our goal is to ensure that you receive the disability insurance benefits you deserve. Don’t let Prudential’s denial deter you—reach out to us for guidance and representation.

Dealing with a disability insurance denial from Prudential can be challenging, but you have options. Robinson Warncke, the leading disability law firm, is here to support you in fighting back against Prudential’s unfair practices. By understanding your policy, recognizing insurance bad faith, appealing denials, and seeking legal assistance, you can assert your rights and pursue the disability insurance benefits you rightfully deserve. Contact us for a free consultation and let us guide you through the process.

FAQs About Prudential Claim Denials

Q: What type of compensation is available in an insurance bad faith claim?

Ans: If your claim is governed by ERISA, then no bad faith damages are available.  However, if you prevail in an ERISA lawsuit you can recover interest on past due benefits and your litigation expenses and attorneys’ fees. If your case is not governed by ERISA, bad faith remedies depend on which state’s law governs your case. Some states do not have a separate bad faith remedy, so you might be limited to recovering the benefits due under the policy.  Some states provide for a separate bad faith penalty of anywhere from 50% to 100% of the amount in dispute. Other states authorize an award of punitive damages limited only by what a jury is willing to award. Some juries have awarded bad faith damages into the millions of dollars, but these outcomes are relatively rare.

Q: How long do I have to file an insurance bad faith claim against Prudential?

Ans: This, too, depends on the law governing your claim. Most group policies governed by ERISA contain a contractual limitation period of 3 years. Some are are even shorter.  In the absence of contractual limitation period, many states have a four or six year statute of limitations. Some states have a different limitation period for the bad faith claim. Determining the exact deadline for filing suit can be complex. If you believe that Prudential has wrongly denied your disability claim, it is crucial to consult with an experienced attorney promptly, preferably before you file an administrative appeal. They can assist you in filing your claim before the statute of limitations expires.

Q: How do I appeal Prudential’s denial of my claim?

Ans: When you receive a denial letter from Prudential, carefully review it as it will provide instructions on how to appeal. Pay attention to the deadline for filing the appeal, which is typically 180 days after receiving the denial. Missing this deadline may result in losing your right to appeal in most cases.  The appeal is when a specialist attorney can do the most good. It can be a serious mistake to try to appeal on your own and only then contact an attorney.  In fact, this can be fatal to your claim.

Your attorney will help you gather the necessary evidence for the appeal. It’s essential to be thorough in demonstrating that you were wrongfully denied the benefits you were entitled to receive. Some evidence that can strengthen your appeal includes additional medical exams to confirm your disability, reports from your treating physician explaining the extent of your disability, opinions from vocational experts stating your inability to fulfill job duties, and testimony from family members or friends regarding the impact of your disability on your life.

Ensure that you introduce this documentation into the claim record, as it may be your last opportunity to do so. In some cases, claimants may be granted a second right to appeal, but often the next step after the appeal is to pursue legal action.

Q: Can Prudential deny my claim for having a pre-existing condition?

Ans: Yes, Prudential can deny your disability claim if it relates to a pre-existing condition. With coverage provided through your work the pre-existing condition clause typically only applies if you become disabled during your first year of employment. Even then, there can be exceptions, for instance if you had disability coverage at your immediate prior employer.

If you have to filed a claim during your first year of employment, the insurer will generally review your medical treatment 90 days (or sometimes up to six months) preceding your coverage date.

Pre-existing condition denials are complicated, and insurance companies often get them wrong. For instance, if you become disabled because of one condition, sometimes the insurance company will invoke a pre-existing condition denial saying you were “at risk” because you had a “related” condition before you became covered, These denials are fairly common, and cna almost always be defeated by an experienced disability law firm.

If you have concerns about a claim denial related to a pre-existing condition, consulting with an attorney experienced in disability insurance can provide valuable guidance. They can assess the specifics of your situation and advise you on the best course of action.

When facing a disability claim denial from Prudential, understanding your rights and options is crucial. Seeking legal assistance from an experienced attorney can help you navigate the complexities of an insurance bad faith claim, ensuring you have the best chance of obtaining the benefits you deserve. Take action within the specified timeframes and gather compelling evidence to support your appeal. With the guidance of legal professionals, you can effectively challenge Prudential’s denial and seek a fair resolution for your disability claim.