Ms. Stewart, a former Alabama attorney, submitted a claim for long-term disability benefits and waiver of life insurance premium benefits with the Hartford. Sadly, she was no longer able to continue working due to the effects of Parkinson’s Disease. Still, Hartford ultimately denied both claims. After filing a lawsuit, Ms. Stewart sought discovery outside of the claim file compiled by Hartford. The Court granted some of Ms. Stewart’s discovery requests.
Discovery in ERISA Cases
ERISA governs disability plans offered by employers to employees. If you receive disability coverage through your job, your claim likely falls under ERISA. Generally, most disability policies contain “discretionary language.” This means the insurance company has the authority to determine whether someone is disabled. As a result of this discretion, most ERISA cases are decided under an arbitrary and capricious standard.
Under an arbitrary and capricious standard of review, insurance companies generally object to all discovery requests. Their position is that the court’s review should be limited to the claim file it compiled. This is no longer the case. Courts now recognize that discovery into extra-record information under an arbitrary and capricious review is permissible, albeit into a limited number of categories.
Ms. Stewart’s Discovery
The court in Ms. Stewart’s case recognized that discovery into extra-record information is allowed to help the court determine whether the insurance company’s denial of benefits was wrong.
In Ms. Stewart’s case, the court allowed discovery into the following issues:
- Hartford’s conflict of interest (as the decision maker and the insurer who pays out benefits)
- How Hartford chose the doctor to examine Ms. Stewart’s cognitive abilities
- The change in claims examiners and how such change impacted the termination of Ms. Stewart’s benefits
Hiring an Experienced Disability Insurance Lawyer is Important
This law firm has always focused only on disability insurance law. Our ERISA lawyers are very familiar with the complexities of ERISA. We help people like Ms. Stewart every day in their fight for disability benefits. This includes successfully seeking discovery from the insurance company.
This firm has significant experience fighting all major disability insurance companies, including Hartford, and has won several major disability lawsuits. Our wins have created new law that protects disabled workers.
We can help with:
- submitting a disability insurance claim;
- appealing a long term disability denial;
- negotiating a lump-sum settlement; or
- filing a lawsuit against your disability insurance company.
The firm represents clients nationwide with disability claims governed by federal law, even if we are not located in your state.