Hartford's refusal to provide entire claim file did not prejudice claimant's ability to dispute her denial of disability benefits
Citation: DiGregorio v. Hartford Comprehensive Employee Benefit Serv. Co., No. 04-2219, No. 04-2252, 2005 U.S. App. LEXIS 19380, (1st Cir. Sept. 8, 2005).
Angela DiGregorio, a secretary for Coopers & Lybrand was insured under the company’s group long-term disability plan. In July 1995, carpal tunnel syndrome forced Ms. DiGregorio to stop working and apply for long-term disability benefits with Hartford Comprehensive Employee Benefit Company (hereinafter “Hartford”) who approved Ms. DiGregorio’s claim for benefits. Pursuant to the terms of her disability plan, she was entitled to receive total disability benefits if she was unable to perform the substantial and material duties of her own occupation. After two years, the policy required that in order to be deemed totally disabled Ms. DiGregorio had to show that she was unable to perform any duty pertaining to any occupation for which she was qualified.
During the review of Ms. DiGregorio’s claim file, Hartford found that Ms. DiGregorio no longer satisfied the policy’s definition of disabled and subsequently terminated her benefits. Hartford based its decision on medical records from Ms. DiGregorio’s orthopedic surgeon, an employability analysis and telephone conversations with Ms. DiGregorio.
Following receipt of Hartford’s termination of benefits, Ms. DiGregorio notified Hartford of her intent to appeal and requested a copy of her entire claim file, including reports and documents reviewed by its medical department or outside consultants. In response, Hartford produced the employability analysis and Dr. Howard’s medical records, but did not produce the entire claim file. Despite numerous requests to obtain the entire claim file, Ms. DiGregorio was unsuccessful.
Ms. DiGregorio submitted an appeal of the denial to Hartford and the decision was upheld. Thus, Ms. DiGregorio files a lawsuit against Hartford. Ms. DiGregorio argued that her claim was not given a full and fair review required under the requirements of The Employee Retirement Income Security Act of 1974 (“ERISA”) because Hartford did not disclose the entire claim file to her prior litigation, despite request for same.
The court held that despite Ms. DiGregorio’s inability to obtain her entire claim file, she was not denied a full and fair review because she was unable to show that Hartford’s failure to produce her complete file prevented her from submitting evidence necessary to dispute the denial of her claim for benefits or absence of the entire claim file impacted her ability to prepare an informed response to Hartford’s denial.
Resources to Help You Win Disability Benefits
Submit a Strong Hartford Appeal Package
We work with you, your doctors, and other experts to submit a very strong Hartford appeal.
Sue Hartford
We have filed thousands of disability denial lawsuits in federal Courts nationwide against Hartford.
Get Your Hartford Disability Application Approved
Prevent a Hartford Disability Benefit Denial
Negotiate a Hartford Lump-Sum Settlement
Our goal is to negotiate the highest possible buyout of your long-term disability policy.
Policy Holder Rating
Truly Horrible and Immoral Company with No Customer Service
Sent my Direct Deposit to a Strangers Bank Acct
Former Hartford employee has had life insurance and accidental death policy's revoked for one late premium payment
Reply
Bad Faith
Denied by Hartford after 20 years of Payments
This company is a scam!
Hartford Stopped Payments
Q: Can the Hartford collect short term disability payments that they say were due to their own mistakes?
Q: Are insurance companies allowed to deny payment of short term disability benefits because I am collecting social security retirement benefits disability?
Q: Does Hartford reduce their monthly LTD payments after 30 months?
Q: Can The Hartford offset my LTD on my VA disability compensation or back pay?
Q: Can Hartford lower my long term disability check if I take my money out of my Vanguard account?
Q: Relocation
Q: Is it possible to write me a strict authorization form for The Hartford?
Q: Denied by Hartford for Long-Term Disability Benefits
Does Hartford Pay Disability Insurance Claims?
How Does Hartford Long Term Disability Work?
What Happens If My Hartford Short Term Disability Claim is Denied?
How Long Does a Hartford Short Term or Long Term Disability Claim Last?
If I Convert my Former Employee Disability Policy to a Private Policy Does ERISA Govern?
Is the Hartford Disability Purchase of Aetna Bad for Aetna LTD Policy Holders?
Hartford Disability Claim Problems
How Can I Protect Myself At A Hartford IME Exam?
Nurse With Knee and Back Disorder Wins Hartford Disability Appeal
Executive Director with Meniere's Denied Long Term Disability Insurance Benefits By Hartford
A Hartford Disability Benefit Lawsuit Victory for Truist Banker with Lupus
Hartford Denies Disability Benefits To Home Depot Employee 3 Weeks Before Change of Disability Definition
Hartford Denies Long Term Disability Benefits After Paying for 22 Years
Hartford Overturns Denial of Disability Benefits on Appeal
Hartford Approves Disability Claim After Appeal Deadline
Hartford overturned its previous denial of LTD benefits for Illinois Account Representative
Reviews from Our Clients






