Prudential Insurance Company Denials Attorney
When Prudential Gets Your Long-Term Disability Claim Wrong
Disability claims administered by Prudential Insurance Company of America are sometimes denied or terminated despite medical evidence supporting a claimant’s disability. When claims are challenged, courts have required Prudential to defend its claim decisions and claims handling practices.
Prudential Insurance Company of America issues both group and individual disability insurance policies, many of which are governed by detailed policy language and federal ERISA regulations.
Our attorneys have experience handling disability insurance and ERISA claims involving Prudential and have litigated cases in which courts ordered Prudential to produce internal claims materials and defend its claims handling decisions.
Where Courts Have Found Prudential Wrongfully Denied Claims
Judicial Scrutiny of Prudential’s Disability Claim Denials
Courts across the country have reviewed Prudential’s disability decisions, requiring the insurer to justify its determinations based on objective evidence rather than selective interpretations. Key legal findings against Prudential include:
- Rejection of “Paper-Only” Reviews: Courts often find Prudential’s reliance on non-examining, file-reviewing doctors to be inadequate when those reviewers ignore the disabling opinions of treating physicians.
- Forced Transparency: In litigation, courts have rejected Prudential’s attempts to hide internal claims handling manuals, training guidelines, and evaluation criteria.
- Consistency Requirements: Judges have criticized Prudential for “intentional self-contradiction”—such as acknowledging a claimant is disabled for Social Security purposes but denying their private LTD claim using the same medical evidence.
Our Successful Cases Against Prudential Insurance Company of America
Green v. Prudential Insurance Company of America
A bank employee with fibromyalgia successfully challenged Prudential’s denial of long-term disability benefits after two denials. Applying the arbitrary and capricious standard due to the plan’s discretionary language, the court highlighted Prudential’s structural conflict of interest as both funder and administrator. It ruled the denial unreasonable because Prudential downplayed fibromyalgia as disabling (despite 6th Circuit precedent recognizing it can be), improperly demanded objective evidence not required by the plan, arbitrarily discounted reliable treating physician opinions, failed to obtain a recommended independent psychiatric evaluation, and issued unclear denial letters lacking a reasoned explanation based on the evidence. The court remanded the claim to Prudential for proper reevaluation.
Myers v. Prudential Insurance Co. of America
A division manager disabled by a blood disorder, asthma, and severe fatigue successfully challenged Prudential’s termination of long-term disability benefits after receiving them for over two years. Prudential relied on weak employer/physician notes and a non-examining file reviewer who ignored the treating physician’s detailed opinion of total disability. Meanwhile, Prudential’s own Allsup representative obtained Social Security disability benefits by arguing the claimant was totally disabled. The court, applying arbitrary and capricious review, found Prudential’s decision unreasonable due to selective evidence use and failure to address the SSA award, reversed the denial, and ordered full reinstatement with back benefits, interest, and attorney’s fees.
Why Prudential’s Claim Practices Matter to Your Case
Legal history shows that Prudential’s benefit determinations must comply with governing law, specifically ERISA (the Employee Retirement Income Security Act).
1. Failure to Explain Rejections of Medical Evidence
As noted by the Ninth Circuit in Salomaa v. Honda Long Term Disability Plan: “Prudential’s failure to adequately explain why it rejected significant evidence supporting disability undermines the reasonableness of its decision.”
2. Financial Pressure on Decision Makers
In multiple cases, courts have permitted discovery into employee evaluations and compensation structures to determine if internal financial pressures influenced wrongful claim terminations.
How We Approach Prudential Disability Claims
Our attorneys at Eric Buchanan & Associates represent individuals whose disability claims have been denied, guiding them through the complex appeals and litigation process. Our approach focuses on:
- Reviewing Policy Language: Analyzing the specific legal standards that govern your claim.
- Evaluating Evidence: Scrutinizing medical and vocational evidence within the administrative record.
- Identifying Procedural Errors: Pinpointing deficiencies in Prudential’s evaluation process to challenge denials.
- Record Development: Ensuring the strongest possible evidence is submitted during the critical appeal stage.
Have you received a denial letter? Proper development of the record at the appeal level is essential to preserving your rights under ERISA law.
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Our Role As Advocates
We represent individuals whose disability claims have been denied and guide them through the appeals and litigation process. Our role is to ensure that claims are evaluated fairly, that insurers are held to the standards required by law, and that court rulings governing disability claims are properly applied.
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.
Please use the contact form below to request your free consultation today, or call us at (877) 634-2506.