“I was pregnant and my job was very stressful at the time. I talked with my supervisors and they said I should apply for short term disability (STD) benefits,” says Angela. She was on STD for about four months and then maternity leave kicked in. Angela planned on returning to work when her daughter was six months old but she couldn’t function – she could barely leave the house.
“While I was pregnant I developed preeclampsia and almost died. That’s when everything went south,” says Angela. “I went into early labor and my daughter Mariah now has developmental issues. I tried to go back to work but couldn’t stop crying—obviously I couldn’t do my job.” Mariah is Angela’s third child. She had never suffered any kind of depression before; neither does depression run in her family.
After attempting to go back to work a few times, HR told Angela that she should apply to Hartford for long-term disability (LTD) benefits. Clearly this depression had made her 100 percent disabled. Her family doctor prescribed antidepressants and Hartford told her she had to go to counseling before they would approve LTD benefits. If you have never suffered from depression or a serious mental illness, arranging and going to counseling seems like a no-brainer. But for someone in Angela’s situation it was insurmountable.
“I tried to book an appointment with the counselor and they were always full so I was on a waiting list,” Angela explains. “Hartford said that I wasn’t trying hard enough, but how could I have done any better? So Hartford denied my claim and then I was fired. I had worked in security at the hospital for five years and I lost all my benefits. That made me even more depressed.”
Angela is a single parent, trying to make ends meet. She certainly didn’t have the means or wherewithal to appeal Hartford’s denial. And to top it off, Angela says she was wrongfully terminated by the hospital.
Hartford’s Independent Medical Examiners
The Hartford Insurance Company has a history of unreasonably denying its policy holders longterm disability benefits. Angela was ordered by one of Hartford’s independent medical examiners to seek counseling without even so much as talking to her. Perhaps she was denied benefits by someone like Spyros Panos, who was at one time a successful orthopedic surgeon. But his surgical practice came to an end after he was found to be inflating charges and billing for surgeries he didn’t perform, and he pled guilty to fraud in federal court in 2013, according to Insurance Journal.
But that’s not all. Panos posed as another doctor while waiting to be sentenced: he reviewed thousands of medical records in coverage disputes for Hartford and a few other insurance companies.
(Insurance companies hire physicians to weigh in when they disagree with patients and often with their doctors about what medical care should be covered. For example, if Hartford declines to pay for an expensive therapy to help a car crash victim walk again or experimental drugs for a cancer patient, the patient can appeal for an independent review.)
READ MORE LTD INSURANCE FRAUD LEGAL NEWS
Back to Panos. Bloomberg reported that Panos collected $876,000 since 2013 from reviewing medical claims. According to state officials, he recommended denying most claims. How his fraud went undetected for years raises concerns about Hartford’s independent medical examiners and bad faith insurance. How many people like Angela did he deny? Angela and her family would likely be managing if Hartford hadn’t been so heartless.