4 Ways Aetna Tries to Deny Long-Term Disability Claims (And How You Can Strengthen Your Case)
Aetna, as part of The Hartford, is one of the nation’s leading disability insurance providers. Aetna’s policies promised to provide financial security to policyholders who cannot work due to an accident, injury, or illness. Unfortunately, the insurance company will often deny legitimate claims for short-term and long-term disability benefits to protect its profits.
If The Hartford or one of its subsidiaries denied your disability claim, you may be considering hiring a long-term disability attorney. Bryant Legal Group’s experienced team of disability insurance lawyers can help you navigate the appeal process. We have a long history of handling cases involving both Aetna and The Hartford, and have recovered millions in benefits for our clients.
In this article, we will discuss common tactics insurance companies may use to justify denying your disability claim, as well as how hiring a disability law firm early on can be crucial to your case’s success.
The Hartford Processes All Aetna Disability Insurance Claims Today
For years, Aetna offered individuals and companies a variety of health, disability, and life insurance plans. However, in 2017, it sold its disability insurance and life insurance divisions to The Hartford for $1.45 billion. With the acquisition, The Hartford became the second largest disability insurance carrier in the United States.
So, what does this mean for you? Even if you purchased your policy from Aetna decades ago, The Hartford will review and process your claim for disability insurance benefits.
What to Expect During an Aetna Disability Claim
Most long-term disability claims involve a series of steps.
- Application: you complete a series of forms and provide the insurance company with information about your medical conditions, limitations, and ability to work.
- Investigation: The insurer assigns your claim to an adjuster who will review your claim and make an initial decision (either approving or denying your claim). During this phase, the adjuster might ask you for more information, send you to an independent medical examination, or consult with physicians. You will get written notice of the adjuster’s decision.
- Appeal: If Aetna or The Hartford denies your long-term disability insurance claim, you have the right to appeal. However, this process will vary depending on whether you have a privately purchased policy or an employer-sponsored disability plan.
If you do not have a long-term disability lawyer, you will have to handle this entire process yourself. That might mean a lot of phone calls, letters, and inquiries from the adjuster and other insurance company representatives. They might even pressure you to participate in field visits—which are really an excuse for surveillance.
That is why many claimants work closely with an Aetna long-term disability attorney. When you are represented, your lawyer will handle all the details and deadlines, and the adjuster must run all communications through your attorney’s office (instead of calling you).
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Common Tactics Disability Insurance Companies Use to Deny Your Claim and How to Avoid Them
Disability insurance companies like Aetna and The Hartford will often attempt to use a variety of different tactics to deny your disability claim. Knowing what these tactics are can help you to prepare yourself and strengthen your case. These tactics do not always hold up in a court of law, so it is important to know all you can to protect yourself against potential disability insurance denial.
1. Insufficient Objective Medical Evidence
Objective evidence is a main reason for many wrongfully denied claims, but this is often not considered s legitimate reason for disability insurance denial. Since many claims are based on subjective symptoms like pain and fatigue, it is sometimes impossible for injured persons to get objective results from tests like CAT scans, blood tests, and others.
This being the case, most of Aetna and The Hartford’s disability insurance policies do not require objective evidence for a claim to be filed. If you are denied this reason, take a closer look at your claim with a disability lawyer to see if you were subject to a wrongful denial. Insurance companies are often not allowed to deny claims for this reason, so be sure to stay aware of any attempts to do so.
2. Disability Definitions
The definition of disability varies based on what policy or what insurance company you may have. Knowing the definition that dictates your coverage is key to winning and maintaining your disability benefits. Your disability insurance coverage will fall into two categories that vary in degree of severity.
Own occupation disability insurance will cover you if you can prove you are unable to perform your own occupation, while also meeting all other disability criteria. All occupation disability insurance requires you to prove you are unable to perform any job at all.
Some insurance companies have policies that will change from own occupation to any occupation after a certain period. Be sure to check your own policy to ensure you can qualify for your definition and to protect against any potential surprise changes.
3. Medical Improvement
Your disability insurance company will most likely ask you for periodic updates on your condition to determine if they will continue paying your monthly benefits. When your insurance company asks for these updates, it is important to be honest about the severity of your condition. Don’t downplay any pain or inconvenience you may be facing, as it could cost you your disability benefits.
4. Conducting Surveillance
Insurance companies like Aetna and The Hartford will occasionally use private investigators to perform surveillance on your everyday activities. These investigators will observe you in any public space they can and are allowed to record you in such spaces. Insurance companies will use this video to prove your limitations are not legitimate and deny your claim.
If you have recently filed a disability insurance claim, pay attention to any unusual activity you may notice soon afterwards. Be sure to avoid pushing yourself beyond your limits, as an investigator could get video evidence of such activity and use it to deny your claim.
- RELATED ARTICLE: Is Someone Watching Me? LTD Claims and Surveillance
The Importance of an Aetna Long-Term Disability Attorney
Many of the intricacies of how insurance companies may attempt to deny your long-term disability insurance claim can be difficult to navigate on your own. Hiring a disability lawyer early on can be the difference between insurance companies denying your claim and you receiving your disability benefits in full.
Filing disability claims are a process filled with endless steps and paperwork, which makes having the assistance of a disability lawyer all that more valuable. Many professionals wait too long to speak to an experienced disability lawyer and regret it. At Bryant Legal Group, we see many claims that are unable to saved due to a delay in communication.
What Qualities to Look for in Your Disability Benefits Attorney
Being sure that you pick the right disability lawyer can be stressful but is important to ensuring the success of your claim. Make sure to ask the right questions to see if your attorney is the right fit for your case. The right experienced disability lawyer should have most, if not all, of the following qualities:
- Specializes in disability insurance law
- Knowledge of your local laws and statutes
- A locally based office
- Honest, empathetic, and upfront
- RELATED ARTICLE: 5 Essential Questions You Should Ask a Disability Insurance Lawyer
Bryant Legal Group: Here to Protect Your Long-Term Disability Benefits from Insurance Companies
At Bryant Legal Group, we have a unique perspective on disability insurance law. Our disability insurance attorneys have decades of experience helping disabled professionals stand up to disability insurance companies to get the benefits they deserve. We are committed to providing professional and result-oriented service and are here to help you understand your disability insurance claim options.
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