Hartford/Aetna Claim Denials Attorney

Need Help With A Hartford Or Aetna Disability Claim?

Disability claims administered by Hartford and Aetna are sometimes denied or terminated despite medical evidence supporting a claimant’s disability. When these claims are challenged, courts have required Hartford and Aetna to defend their claim decisions and claims handling practices.

Hartford and Aetna are discussed together on this page because Hartford administers most policies originally underwritten by Aetna and courts reviewing denied claims have examined their claims handling practices under similar legal standards.

Our attorneys have experience handling disability insurance and ERISA claims involving Hartford and Aetna and have litigated cases in which courts examined their claim handling decisions and procedures.

Documented History Of Hartford And Aetna Claim Practices

  • Courts have examined how Hartford and Aetna evaluated disability claims, including their review of medical evidence and the administrative record.
  • Judicial rulings have required Hartford and Aetna to defend claim decisions where benefits were denied or terminated under group disability policies.
  • Courts have permitted scrutiny of claims handling procedures when reviewing Hartford and Aetna disability claim determinations.

Our Successful Cases Against Hartford/Aetna Insurance Companies

Bates v. Hartford Life and Accident Insurance Company

The District Court of Idaho ruled that a former American Family Insurance agent’s state law claims for breach of contract and bad faith were not preempted by ERISA, allowing her to pursue remedies outside of federal statutes. Although the plaintiff’s original coverage was part of an ERISA-governed employer plan, the court determined that the Northern Trust Plan she transitioned to was a conversion plan—an independent policy triggered upon her resignation. Applying Ninth Circuit precedent from Waks v. Empire Blue Cross/Blue Shield, the court found that because the Northern Trust Plan was not established or maintained by an employer, did not cover any active employees, and involved no administrative role by American Family, it failed to meet the statutory definition of an “employee welfare benefit plan.” Consequently, because the conversion policy functioned as an individual contract rather than an employer-sponsored benefit, the plaintiff’s claims remain governed by state law.

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Santorelli v. Hartford Life and Accident Insurance Company

In this disability benefits case, the court reviewed de novo Hartford Life Insurance’s denial of a program manager’s long-term benefits after she was diagnosed with a severe vascular disorder that required heavy immunosuppressants. While Hartford argued that the claimant remained capable of performing the sedentary “essential duties” of her occupation based on a consultant’s report, the court found Hartford’s analysis flawed for failing to address the medical necessity of her working from home. The court credited the testimony of the claimant’s treating physicians—who advised against office environments due to her immunocompromised state—over Hartford’s “speculative” evidence of her performing minor outside tasks like grocery shopping. Consequently, the court remanded the case for Hartford to conduct a “speedy full and fair reconsideration” of whether working in a physical office constitutes an Essential Duty of her occupation, as her medical condition rendered her unable to perform work in a communal setting.

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Neaton v. Hartford Life & Accident Insurance Company

In Neaton v. Hartford Life & Accident Ins. Co., the Sixth Circuit Court of Appeals reversed a lower court’s ruling, finding that Hartford acted arbitrarily and capriciously when it terminated the long-term disability benefits of a 32-year employee with a worsening progressive condition. The court determined that Hartford’s denial was based on unreasonable estimations of recovery time and surgery frequency provided by non-examining peer reviewers and vocational experts who ignored the claimant’s deteriorating health. Specifically, Hartford’s experts underestimated recovery times by assuming a work-from-home accommodation that did not exist and calculated absenteeism using outdated data from before the claimant’s condition became disabling. Because Hartford failed to justify its reliance on these flawed reports or verify with the employer whether such high rates of absenteeism could actually be accommodated, the court ruled the denial was unsupported by substantial evidence. Consequently, the court ordered the retroactive reinstatement of benefits, emphasizing that such a remedy is appropriate when a claimant’s existing benefits are wrongfully terminated.

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Experience With Erisa And Long Term Disability Claims

Our attorneys at Eric Buchanan & Associates represent policyholders nationwide in ERISA governed disability and long term disability insurance claims. We have experience handling claims involving Hartford and Aetna and have represented clients in cases where courts reviewed and evaluated their disability claim determinations.

Our work in this area includes navigating the ERISA administrative process and litigating cases where judicial review was required to assess whether benefit decisions complied with applicable law.

Hartford And Aetna’s Claim Practices And Legal History

Federal courts reviewing disability benefit determinations issued by Hartford Life & Accident Insurance Company and Aetna Life Insurance Company examine whether the denial was supported by substantial evidence and consistent with the governing policy language. In ERISA cases, judicial review focuses on whether the insurer provided a reasoned explanation grounded in the administrative record.

In Santorelli v. Hartford Life & Accident Insurance Company, the United States District Court for the District of Connecticut closely reviewed Hartford’s evaluation of the medical evidence and its rationale for denying benefits. The court analyzed whether Hartford’s decision was supported by the record as a whole and consistent with ERISA’s standards of review.

Courts addressing claims involving Hartford and Aetna similarly evaluate whether medical evidence was fairly considered, whether vocational findings were supported by reliable analysis, and whether the stated rationale for denying benefits is supported by the administrative record.

Why Hartford/Aetna’s Claim Practices Matter to Your Case

Disability claims administered by Hartford Life & Accident Insurance Company and Aetna Life Insurance Company are frequently governed by ERISA, which often confines judicial review to the administrative record developed during the claims process.

Courts do not retry the case. They often evaluate whether the insurer’s decision was supported by substantial evidence and resulted from a deliberate, reasoned process. If the record does not directly contradict the insurer’s stated grounds for denial, courts may defer to the insurance company’s decision.

Because judicial review is typically limited to the evidence submitted before the final denial, the way a claim is documented and appealed can affect the outcome. Medical opinions must address functional limitations under the policy’s definition of disability, and vocational conclusions must be supported by reliable analysis.

Careful development of the administrative record is critical in claims involving Hartford and Aetna.

Financial Pressure on Claim Decision Makers

Courts evaluating disability claims have recognized that insurers responsible for both claims administration and benefit payments operate under structural conflicts of interest. Courts reviewing claims involving Paul Revere disability policies have considered this context when evaluating benefit determinations based on disputed medical evidence or policy interpretation.

These findings describe conduct established in court. We do not speculate about how claims are handled today.

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How We Approach Hartford And Aetna Disability Claims

Disability claims administered by Hartford and Aetna require careful attention to policy language, medical evidence, and the procedural rules governing benefit determinations under ERISA and applicable insurance law.

Our approach focuses on:

  • Reviewing Hartford and Aetna policy language and the legal standards that govern disability claims
  • Evaluating medical and vocational evidence contained in the administrative record
  • Identifying procedural errors or deficiencies in claim evaluation and administration
  • Applying relevant court rulings to challenge benefit denials and litigation positions

Our Role As Advocates

The court decisions discussed on this page illustrate how judges evaluate disability claims involving Hartford and Aetna by closely examining policy language, the administrative record, and the standards applied when determining eligibility for benefits.

At Eric Buchanan & Associates, we represent policyholders in disability insurance and ERISA claims where coverage turns on how disability is defined, how work duties are evaluated, and how medical evidence is weighed under applicable legal standards.

If your disability claim was denied or terminated under a Hartford or Aetna disability policy, we are prepared to help you evaluate your options and determine appropriate next steps.

Contact Us Today!

You don’t have to deal with the insurance company alone.

If your claim was denied, delayed, or handled unfairly, our team is ready to review your case and help you understand your next steps. Call: (877) 634-2506