Hartford's termination of claims it is currently paying based on surveillance
Plummer | Raval has extensive experience representing claimants against this insurer. Our experience shows Hartford undertakes the following steps to deny or terminate claims.
Hartford uses video surveillance to assist it in terminating claims.
Plummer | Raval has documentation on several firms Hartford hires to investigate and video record claimants.
Hartford often hires expensive surveillance companies who provide embellished reports of claimant activity. One such report described a woman with severe neck surgery pain lifting a child into a car. The claimant has no children of lift able age living with her or in her extended family.
PLUMMER | RAVAL’S LITIGATION STEPS
Plummer | Raval holds a copy of the Hartford claims manual which lists several inherent conflicts of interest in Hartford’s claims review process.
DEFENDANT HARTFORD LIFE’S STRUCTURAL CONFLICT OF INTEREST
Hartford Life operates under an inherent and structural conflict of interest as Hartford Life is liable to pay benefits from its own assets to Plaintiff and each payment depletes Hartford Life’s assets.
Defendant Hartford Life’s behavior corrupts any reasonable meaning of “full and fair review” that ERISA requires.
Hartford Life chooses to conduct reviews of denied claims in order to maintain strict control over its risk of loss and to maintain higher profit margins than it could if a financially independent third party decided the appeals.
As a routine business practice Hartford Life uses the appeals process to support initial benefit denials rather than to review impartially whether Defendant Hartford Life should reverse appealed denials.
Hartford Life's corporate culture pressures claims personnel to deny claims on appeal to reduce the amount of benefits Defendant Hartford Life pays out.
Hartford Life intentionally rationalizes claim denials on appeal by soliciting biased opinions from medical professionals to add strength to its initial claim denials. The medical professionals are contracted by Hartford for extended periods of time and provide Hartford favored medical reviews. The companies listed below are a small example of the companies Plummer | Raval holds documentation on:
- In the past Hartford Life used the services of University Disability Consortium (“UDC”) to whom Hartford Life had paid over $13 million for review services over approximately four years. UDC derived nearly three quarters of its revenue from Hartford.
- In the past Hartford Life also retained a company called Medical Advisory Group (“MAG”) of Plaistow, New Hampshire to whom Hartford Life paid over a million dollars a year for many years for medical reviews.
Hartford Life moves from one medical review company to another that serves its needs while providing an incentive for its doctors not to find insureds impaired so as to increase the likelihood of continuing business.
Hartford Life’s selection of medical review companies such as UDC and MAG shows that Hartford Life does not try to evaluate fairly claims but selects medical review companies and their doctors who will provide expected results, finding that insureds are not impaired.
Hartford Life limits its employees to certain medical vendor companies that they may use for rendering medical or vocational determinations of its insureds.
The medical review company doctors provide significantly more file reviews rather than actual examinations of Hartford Life’s insureds.
Plummer | Raval has information on all past and current “independent” medical examiners Hartford employs.
Hartford’s claims manual describes several other conflicts of interest including incentive programs for employees to deny benefit claims. Hartford Life employees pay special scrutiny to claims that may cause Hartford Life to pay benefits for long periods of time. It is reasonable to conclude that Employees who save Hartford Life money by terminating or denying claims are likely to be rewarded with bonuses compared with those who do not. The Hartford Life claims manual confirms this conclusion and will be used by Plummer | Raval during litigation of any claim against Hartford Life.