Prudential Insurance Company of America
Prudential Insurance Company of America has a well-documented track record of unfair claims practices in disability income and life insurance claims. The California Department of Insurance completed a Market Conduct Examination of Prudential’s claims practices on June 30, 2022. The California Department of Insurance examined 185 disability, long-term care, life insurance, and annuity claim files and concluded that Prudential committed 372 discreet unfair claims practices in the handling of those files. (Prudential denied most of the Department of Insurance’s allegations.)
The California Department of Insurance found that: Prudential failed to provide a clear examination of how it computed benefits with each claim payment; Prudential attempted to settle numerous claims by making a settlement offer that was unreasonably low; and Prudential failed to conduct and diligently pursue a thorough, fair, and objective investigation of disability claims in numerous instances. One unfair practice commonly engaged in by Prudential according to the California Department of Insurance is to have registered nurses review and render opinions on medical records when another medical specialist with a higher medical degree was involved in the claimant’s treatment and disability. Another common Prudential unfair practice according to the California Department of Insurance is that even though Prudential was aware that the claimant had filed a workers compensation claim or sought Social Security Disability benefits, it did not obtain the records from those claims.
The California Department of Insurance also found that in multiple instances Prudential failed to disclose all benefits, coverage, time limits or other provisions of the insurance policy that might apply to the claim presented by the claimant, thus misleading the claimant. In other instances, Prudential persisted in requesting information which it already had received. Prudential failed to decide claims in a timely fashion consistent with California law and failed to pay interest on disability claims which it had not paid in a timely fashion. In one instance, Prudential tried to collect a claimed overpayment in a disability claim more than six months after its discovery that it had made the overpayment, a violation of California law.
The California Department of Insurance found that Prudential failed to conduct and diligently pursue a thorough, fair and objective investigation in 34 instances, often letting claims sit without activity for weeks or months. In numerous instances, Prudential failed to respond to communications within 15 days as required by California law. (Prudential did not dispute those findings.) In numerous instances, Prudential failed to effect prompt fair and equitable settlements of claims in which liability had become reasonably clear.
In the ERISA Law Center’s experience, we have found that Prudential often targets long-time insureds – persons who have been receiving benefits for 15 or 20 years – for termination of benefits. Prudential also frequently misrepresents policy terms and regularly demands repeat independent medical examinations in claims it targets for termination. Prudential also delays appeal decisions on denied or terminated benefits at great length. Whether or not the policy or plan provides for two appeals, Prudential always grants two appeals and routinely does not adequately or fairly evaluate the first appeal, so it almost invariably requires a second “voluntary appeal.” The end result is that the appeal process when a claim is terminated or denied by Prudential can often take up to one year.
If you have a claim for disability benefits or life insurance benefits with the Prudential Insurance Company of America and your benefits have been denied or terminated, the ERISA Law Center can help you. We have represented numerous claimants against the Prudential Insurance Company of America. We are familiar with its unfair claims practices and unfair procedures and have successfully assisted our clients in obtaining, retaining, or reinstating your long-term disability or life insurance benefits from Prudential.