Appealing a Denial of Disability Benefits from Prudential Financial

If your employer offers disability insurance as one of your optional benefits, it may be smart for you to select the option. Disability insurance is designed to replace a defined percentage of your income when you are unable to work because of an injury or illness. Unfortunately, Prudential Financial sometimes denies the claims that people make for disability benefits under their policies. The experienced team of disability lawyers at Osterhout Berger Disability Law are experienced in helping people with their disability denials from Prudential Financial.

What is Prudential Financial?

Based in Newark, New Jersey, Prudential Financial is a publicly traded Fortune 500 company. It has more than 48,000 employees and offers products and services to customers who are located in more than 30 countries. The company offers retirement plans, annuities, life insurance, mutual funds and other insurance products, including disability insurance.

Disability insurance from Prudential Financial

Prudential offers group disability insurance coverage through employers. Employees may choose short-term disability insurance, long-term disability insurance or both. Long-term coverage can start paying benefits when the short-term benefits end. There is an elimination period for both short- and long-term disability payments, meaning that you will not be able to receive benefits unless your disabling condition prevents you from returning to work for a longer time than the elimination period.

Short-term disability insurance from Prudential Financial

Short-term disability insurance with Prudential offers benefits that replace a percentage of the disabled worker’s income for three to six months. Short-term plans normally pay benefits on a weekly basis. Depending on your plan, you may need to meet certain requirements to even be eligible for disability benefits. This could include having an injury or illness that matches Prudential’s definition of a disability or being an employee of your company for a set amount of time. Read your plan carefully to understand what you’re entitled to and what restrictions the plan may have in place. If you have other sources of disability income, like Social Security disability, it may disqualify you from receiving these benefits or substantially reduce the amount you get paid on a weekly basis.

Prudential Financial long-term disability

With long-term disability insurance, you’ll receive a bigger percentage of your income on a monthly basis. However, you’ll typically have a longer elimination period before you can start collecting benefits. If you choose to have both short and long-term disability insurance, you may be able to have less of a gap than if you opted to just have long-term disability. The same requirements that are set for short-term disability may apply to the long-term plan. This means that your disability must fall within Prudential Financial’s definition of a disability. Again, make sure to read your plan thoroughly to understand what you’re entitled to and what restrictions may apply.

What you need to know about Prudential Financial’s disability claims

While this insurance company alleges that they have “a better claims experience”, they have been known to cut corners by either delaying or denying claims. One way they may cut corners is by stating that claimants haven’t provided sufficient documentation proving that they have an eligible disability. For this reason, it is extremely important that you not only fill out the claims form as accurately as possible, but that you also keep record of all documentation provided by your doctor.

How to submit a disability claim to Prudential Financial

You can submit a disability claim online through Prudential’s Workplace Benefits portal. Both the short-term and long-term disability claims paperwork are essentially the same. The insurance company will require you submit an employee statement, an employer statement, and your attending physician’s statement. You have the option to fill out a disability insurance authorization form that gives the insurance company permission to retrieve all the medical information it’ll need to come to a decision. It may be best to fill out that form early rather than waiting for your case manager to request it later on in the process. Once you’ve submitted all of the necessary forms, you’ll be contacted by a case manager. This case manager should walk you through the next steps and be available to you should you have any questions.

What to do if Prudential Financial delays your claim

If you feel as though your claim is being delayed, your case manager should be the first person you contact. Ask them for the reason behind the delay and check to see if there’s any additional paperwork they need from you in order to move the process along. If they don’t give you a straight answer or talk in circles, it may be best to get a disability lawyer involved. Experienced disability lawyers are familiar with the games insurance companies often play to prolong having to pay benefits.

What to do if Prudential Financial denies your disability claim

Unfortunately, Prudential initially denies many claims for benefits. If it denies yours, you will be notified by mail. In your letter, you will be able to read the reasons why the company arrived at its denial decision. You will also be given information about how to appeal the decision and your deadline for filing your appeal.

Appealing a denial from Prudential Financial

Read your denial letter very carefully as it should have instructions on how to appeal your denial along with the deadline to file your appeal. This deadline is very important. If you miss it, you won’t be able to try again to recover your disability benefits from Prudential. You are also not able to sue the company in court without first going through its own appeals process. When you receive your denial notice, request a copy of your claim file from Prudential and bring it and your denial letter to your appointment with the disability lawyers at Osterhout Berger Disability Law.

Try to limit any discussions about your claim with Prudential and ask that all communication about it is conducted in writing. It is important that you avoid exaggerating about your symptoms. If you do, it may be considered to be evidence of malingering, making it very difficult for you to win your appeal. When you meet with your experienced lawyer, you should also make sure to listen to the advice you are given. Your attorney’s goal will be to help you to build the strongest appeals case possible, and the advice that he or she gives to you will be to help further that goal.

You may need to do certain things to help with your appeal. When you are able to add favorable evidence for your claim to your file, you are likelier to win. Your attorney might want you to submit to more tests and to get statements from your doctor and former employer about how your condition affects your ability to do your job. By getting these additional pieces of evidence, you may make your claim stronger so that winning while it is still held within Prudential’s internal process is likelier. Finally, your attorney may help you to file your appeal within the company’s deadline so that you can pursue your recovery rights. Contact the experienced disability lawyers at Osterhout Berger Disability Law to schedule your consultation.