Hartford Uses Half-Baked Review to Terminate Benefits for Ontario Cancer Patient
Our Ontario, Canada-based client was living his dream working as a mergers and acquisitions manager in California when he was diagnosed with primary bone lymphoma at only 28 years old. He returned to Ontario to seek treatment and underwent 6 cycles of chemotherapy. After his treatment, our client suffered from chemo-induced irritable bowel system (IBS) and cognitive impairment. The severity of our client’s treatment-induced symptoms prevented him from fulfilling the duties of his occupation, forcing him to file a claim for long-term disability benefits (LTD) benefits under his employer’s group disability policy.
Hartford approved our client’s LTD claim but began reviewing it only 6 months later. During a poorly conducted review, Hartford decided to ignore overwhelming evidence and terminate our client’s LTD benefits, violating the terms of his policy.
Fortunately, our client contacted Dabdoub Law Firm.
Overwhelming Medical Evidence
Hartford based its termination of benefits on an erroneous review from an “independent” physician whose career is based on writing reviews on behalf of various insurance companies. Although the doctor admitted our client suffered from medical conditions, he claimed those conditions did not prevent our client from working.
Additionally, Hartford did not request an independent medical evaluation nor perform any evaluation of our client’s cognitive impairments.
On the other hand, our client’s treating physicians have concluded that he is unable to work. Our client’s gastroenterologist provided Hartford with x-rays of gastrointestinal obstruction due to our client’s IBS and supported his claim of disability. IBS causes our client intense pain and interferes with his ability to reliably work full-time. Our client’s oncologist agrees with this determination, highlighting significant residual side effects from our client’s cancer therapy, including ongoing migraine headaches, fatigue, cognitive difficulties, and “mental fog.”
To further prove his disability, our client underwent an independent neurophysiological evaluation with the former president of the Illinois Psychological Association. This professional has more than 26 years of experience and determined our client’s cognitive deficits would significantly interfere with his ability to perform the responsibilities of his job. The doctor also noted that our client’s cognitive impairment worsened after lunch as a result of his severe IBS.
Further, our client attended an independent functional capacity evaluation to provide even more objective clinical evidence. Here, a physical therapist confirmed our client did not demonstrate an ability to perform within a sedentary occupation because he was unable to sit or stand for at least 2 hours at one time. Once again, our client’s symptoms were worse after consuming a light meal that triggered his IBS.
Multiple independent peer reviews confirmed our client’s symptoms, including migraine headaches and other common conditions linked to chemotherapy. With all this evidence, relying on one flawed medical review from a doctor who had never examined our client seems irresponsible at best. Hartford did not act in our client’s best interests.
Hartford’s Failure to Act in Our Client’s Best Interests
Under the Employee Retirement Income Security Act of 1974 (ERISA), Hartford has a fiduciary duty to its client as must act “solely in the interest of the participants and beneficiaries and . . . for the exclusive purpose . . . [of] providing benefits to participants and their beneficiaries.”
Instead of upholding its legal duties, Hartford ignored evidence of disability and cherry-picked the medical reports in an unfair termination of benefits. Because our client received a larger than average LTD benefit, Hartford chose to put its own financial interest above all else.
Dabdoub Law Firm offered Hartford an opportunity to avoid litigation and correct its errors, recognizing our client’s tragedy and upholding its historical commitment to beneficiaries.
Fortunately, Hartford took advantage of the opportunity, reinstated our client’s benefits, and paid his retroactive benefits in full.
Help from a Lawyer with Expertise in Disability Insurance
Dabdoub Law Firm was built to be a disability insurance law firm.
That focus means:
- All of our lawyers specialize in disability insurance claims.
- We have experience with every major disability insurance company.
- We have won important long-term disability lawsuits.
Our disability lawyers can help you 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.
Hiring an experienced disability attorney is important. Because federal law applies to most disability insurance claims, our lawyers do not have to be located in your state to help.
Call us at (800) 969-0488 or contact us online for a free consultation with an experienced disability attorney. Pay no fees or costs unless you recover the benefits you deserve.