Guardian Life Insurance Company/Berkshire is one of the largest disability insurance companies and is well-regarded. Guardian sells both individual disability insurance policies (known sometimes as private disability income policies) and group policies, offered by employers as part of employee benefit packages and governed by the federal law ERISA.
Guardian/Berkshire is known as a premium insurance company and targets high-income earners like doctors, lawyers, C-suite executives, investment professionals (floor traders, stock brokers), and business owners, to name a few. The premiums are higher than most LTD policies, with the expectation that the coverage and customer service will be exemplary.
People who file claims for disability insurance benefits with Guardian/Berkshire are surprised and disappointed when, despite years or decades of paying high premiums, their coverage is denied.
Newfield Law Group has represented many private and group LTD policyholders who thought they were getting a luxury experience by relying on Guardian/Berkshire. If you have a Guardian/Berkshire long term disability insurance policy and are preparing to file a claim, have had your claim denied or terminated, call us to learn about our experience representing claimants against this insurance company.
Why Did Long-Term Guardian/Berkshire Deny My Disability Insurance Claim?
As a national disability law firm, we follow trends in denials from the calls and emails we receive and the financial news coming from insurance companies. We are frequently called by claimants who have had their Guardian LTD claim denied, and they are almost always completely surprised. Lately we are seeing many more calls from high-income wage earners who were being paid by Guardian regularly for several years and then, despite there being no change in their medical condition, their claim is suddenly terminated.
Here is our perspective: the original The Guardian Life Insurance Company of America merged with Berkshire Life Insurance Company of America in 2001 and has been buying up insurance companies, health provider companies and third party management companies ever since. As the company has grown to one of the largest mutual insurance companies in the U.S., the need to protect itself from overexposure from policies sold by Guardian and other companies has grown also.
Newfield Law Group has more than two decades of representing claimants against Guardian and other insurance companies that wrongfully deny claims to policyholders. Our experience and knowledge of this company and how they push back on paying claims gives our clients an advantage. Call us to discuss your situation and learn how we can help.
Private Individual Disability Policies
Before you can purchase a private or individual disability insurance policy from Guardian, you had to undergo an extensive review of your health, career and in some cases, financial well-being. The Guardian is known for having one of the stricter underwriting guidelines in the disability world. This is done to protect the company from people who may not be able to afford the high premiums and who are less likely to file a disability claim. Many medical professionals chose Berkshire for insurance right of our residency, never expecting to rely upon it. When it is time for the insurance company to keep its promise, it is time to engage Newfield Law Group.
Business Disability Insurance
Business owners are often Guardian disability policy holders, as they need disability insurance to ensure their family will continue to maintain their lifestyle if they are unable to work. Guardian also sells “key man” insurance policies, disability insurance to cover business loan payments and other expenses of running a business. For a business owner, this makes sense—until the coverage is denied. We represent many business owners who consider their purchase of business disability insurance a necessary investment in protecting their business and were denied benefits.
Partial or Residual Disability Insurance
For those who are able to work but not at their full capacity, it is important to review the partial or residual provisions of the policy. Depending upon the language of the policy, the residual or partial disability coverage protects against the person’s loss of income rather than their inability to work. Benefits are supposed to begin when the claimant loses a certain percentage of their income because they are not able to work to full capacity due to a disability.
For the wage earners who are able to work at a reduced level, the partial or residual disability coverage is a great aspect of disability insurance—as long as it is paid as it was promised. The person does not lose their entire professional identity but they are able to work in a reduced capacity and not put their health at risk. The problem comes when the insurance company determines they are not disabled, or do not have enough of a disability to be paid residual benefits. Many do not even understand the policy terms for a residual or partial disability claim.
The partial or residual disability provisions can be found in both private and group/ERISA disability insurance policies.
Guardian’s Own Occupation Disability Insurance Policies
Because Guardian sells policies to professionals, including lawyers, CPAs, doctors, and dentists, many of the policies are “own occupation” policies, insuring the person’s ability to work in the occupation for which they have devoted time and resources. This includes most professionals who are licensed or granted credentials by groups like the American Dental Society, the American Medical Society, the American Bar Association, and other national associations.
The person’s ability to perform the material tasks and duties of their own job is often challenged by Guardian and other insurance companies. The denial typically says their occupation is sedentary and based on the medical reports submitted, they are not disabled from their occupation.
Our law firm is familiar with the tactics used by Guardian and their representatives to deny claims. We invite you to call the firm to discuss your unique situation and get the perspective of an experienced long term disability attorney.
