Prudential Long-Term Disability Denial

Prudential is a Fortune 500 company that’s made upwards of $41 billion in profits. Like other huge insurance companies, Prudential knows that by denying legitimate claims and giving policyholders the runaround, they can increase their profit margins. If you received a Prudential long-term disability denial, an Ocala LTD attorney at CJ Henry Law Firm, PLLC can help.

History of Bad Faith Practices

Aside from denying legitimate claims, Prudential’s bad faith practices include delaying benefit claim payments and convincing policyholders to settle for less money than they deserve. They count on wearing you down so you won’t put up a fight.

Don’t fall prey to these tactics. A qualified disability attorney can be your advocate when you’re too sick to pursue your claim or if you’re struggling financially.

Protect Yourself by Understanding Your Policy

The purpose of disability benefits is to replace part of your income if you become disabled and unable to work due to accident or injury. And the basic difference between long and short-term disability benefits is the amount of time the policyholder can collect benefits.

All insurance companies, including Prudential, determine which disabilities they will cover and which disabilities they will exclude. Prudential’s exclusions may include certain types of injuries or conditions regardless of the seriousness of the disability. Understanding your specific policy can help you avoid the tactics Prudential uses to delay or deny claims.

Prudential routinely refuses to pay benefits for disabilities caused in the following:

• Self-inflicted injuries
• Any war or act of war even if war is undeclared
• Participation in a riot
• Injuries sustained in the commission of a crime for which you were convicted

Individual and group disability insurance policies must include the criteria they use to determine eligibility. Read your policy carefully because the terms disability or disabled may not be defined in the way you expect. Understanding the terms of your policy will prepare you when filing your claim.

How Does Prudential Determine Disability?

One way Prudential determines whether or individuals qualify for long-term benefits is whether or not they can perform their jobs. If you are unable to perform the primary duties of your occupation, Prudential will consider you disabled under some policies.

You are considered partially disabled if you:

• Are unable to perform the primary duties of your current occupation
• Have a total disability or at least a 20 percent loss of monthly income
• Are under a physician’s care and receiving treatment

You’re considered totally disabled if you:

• Are unable to perform the duties of any occupation which you are reasonably qualified to do
• Are under a physician’s care and receiving treatment

For total disability, you’ll generally receive benefits for 24 months. However, after 24 months you’ll have to prove you are still eligible for benefits.

How to Spot Bad Faith Practices

Insurance companies have the right to deny claims that do not meet the conditions of policy coverage, but they are legally obligated to act in good faith whenever a policyholder files a claim. Unfortunately, Prudential and other insurers may employ bad faith practices to avoid paying long-term disability benefits or delaying payments for legitimate policies. Here are a few bad faith practices you should be aware of:

• Asking for endless copies of paperwork and claiming documents were lost or never received
• Contacting your physician repeatedly for additional medical information
• Delaying a claim decision as long as possible to avoid paying benefits
• Claiming your medical records are out of date or incomplete
• Trying to convince you to accept a reduced benefit instead of the full amount you’re due
• Claiming you misrepresented your disability or that your disability is a pre-existing condition
• Assigning your claim numerous times to different claims representatives to delay processing

You Have the Right to File an Appeal

Anytime you receive a denial of benefits from Prudential or another insurance company, you still have options. If you have a private disability policy, you might be able to file a lawsuit against the company directly. If you are part of a group disability policy, you can file an appeal. Be sure to meet all policy deadlines for the appeal. As part of an employer-provided plan, you also have the right to file an appeal.

Don’t give in to Prudential’s attempts to wear you down and walk away from benefits you deserve.

Don’t Be Intimidated by a Prudential Long-Term Disability Denial

Contact the attorneys at CJ Henry Law Firm PLLC today to learn more about how to fight a Prudential long-term disability denial.