Multiple Sclerosis Patient Wins Appeal Against The Hartford
Multiple Sclerosis is a progressive disease that has left our client totally disabled. Our client had a disability insurance policy through her employer with The Hartford Insurance Company. Hartford paid her long term disability benefits for nine years when they unjustly terminated her benefits. The decision was based on the misapplication of a bonus she received.
The Hartford Insurance Company received an earning statement for our client ranging over about a year and half. Included in that statement were two bonuses she received from her employer. One bonus was a stock option plan bonus. The other bonus was in recognition for her many years of service.
In calculating her earnings, Hartford prorated the stock option plan bonus over 12 months. However, they applied the service award bonus to one month earnings. With that, The Hartford found that she earned too much money in that one month and terminated her benefits.
Hartford purposely applied the service award bonus to one month’s earning as opposed to prorating it like they did the other bonus, in order to end her benefits. This was an unfair move by The Hartford. And it was against the policy.
We filed an appeal of the termination of benefits alleging that Hartford erroneously applied the service bonus to one month’s earnings. We also alleged they had waived their right to terminate her benefits based on the bonus. Since the bonus was given almost a year and half before the termination, Hartford waited over a year before taking action and terminating her benefits.
There is case law that says if an insurance company is aware of something that may disqualify a person from continuing to receive benefits under the policy, they cannot wait to act on it. Waiting over a year to do anything effectively waives the insurance company’s right to terminate benefits, seek reimbursement of any benefits paid, or recalculate benefits.
Unfortunately, multiple sclerosis is a disease our client will suffer from her whole life. She will continue to be totally disabled. It is a progressive disease and presents a huge liability to any insurance company. However, that is no excuse for an insurance company to find ways to deny or terminate disability benefits for financial gain. Especially for someone suffering from a disease like multiple sclerosis.
With our appeal letter and a letter from her employer confirming the nature of the service bonus, Hartford reinstated her long term disability benefits. She will continue to receive her long term disability benefits from The Hartford for as long as her policy allows.
Because each client’s case is unique and has different facts, results similar to those in other clients’ cases are not guaranteed.