Federal District Court Finds That Hartford Failed To Provide A Claimant With A Full And Fair Review Of Her ERISA Governed Disability Insurance Claim.
On Behalf of Disability Insurance Law Group | | ERISAIn a recent case out of the Southern District of Indiana, Miller v. The Hartford Life And Accident Insurance Co., & Springleaf Finance, Inc. Disability Plan, No. 116CV00166TWPDML, 2017 WL 2214938 (S.D. Ind. May 19, 2017), the federal court found that Hartford failed to afford the Plaintiff a full and fair review of her ERISA governed disability insurance claim and remanded the matter back to Hartford to reevaluate the claim.
The court found that due to a scanning error of Hartford’s vendor, Xerox, the first two pages of the Plaintiff’s Physician’s Statement was not included in Hartford’s claim file and thus, Hartford failed to consider the evidence in rendering its decision to deny Plaintiff’s claim. The two missing pages contained “critical information regarding Miller’s medical condition and capacity to work.” Hartford admitted that its failure to evaluate the information resulted in and incomplete and unfair claim evaluation and filed a motion to remand the matter to Hartford and stay the proceedings while it reviewed Miller’s claim. Miller objected to Hartford’s motion, arguing that Hartford was negligent in failing to notice that the two pages of the Physician’s Statement were missing from its file during its initial review. However, the court found that the issue of whether Hartford was negligent was immaterial to whether it provided Miller with a full and fair review and the matter had to be remanded so that a complete evaluation could occur.