Disability Claims Solutions

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If someone were to ask me today which insurance company was the worst for disability insurance I would have to say Prudential. While most insurers at least attempted to accommodate and act humanely during COVID, Prudential did not. Staffed with former Unum employees and management, Prudential is the resultant master clone of targeting claims.

Prudential has always been one of the group disability “bad boys”, with strategies occasionally surpassing Unum’s. Years ago, as well as today, Prudential’s ability to misrepresent and “read into” mental health records is unprecedented. The company has gone so far as to deny claims when therapists refuse to provide actual psychotherapy notes. Barring that, Prudential allows medical reviews by RNs who have no speciality experience in the area being reviewed, particularly mental health.

The practice of using RNs to approve or deny claims with large financial reserve values is unacceptable and inappropriate. But, Prudential also solicits peer review reports from old Unum “claims killers” who are infamous for writing adversarial medical reviews. No harm in using what works, right? Wrong.

More recently, Prudential failed to approve a claim obviously targeted 6 months before 1st Qtr. profitability reporting. Despite multiple submissions of paperwork supporting disability Prudential’s opinion to deny remained the same. Therefore, I think it’s reasonable to say that once a claim appears on a Prudential target list, it won’t come off until it’s denied.

Claimants with Prudential Plans need take extra care to make sure favorable points of view are put in the record. Staying on top of miscommunications is also essential.

Prudential is also a master at denying LTD claims during the last weeks of STD so that claimants do not meet the EP for LTD. This is an unfair claims practice that seems to be unique to Prudential.

Just keep in mind that Unum is not the only group disability insurer with unfair claims practices. Prudential is also at the top of the list of for unfair claims practices along with CIGNA (Lincoln), and The Hartford. Mass Mutual is the main offender in the IDI category.