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The Guardian Life Insurance Company of America (Guardian) has an interesting history. It was founded by Hugo Wesendonck, a German civil right lawyer who participated in the 1848-1849 revolt and helped write the German constitution.

He ultimately was forced to flee Germany and settled in Manhattan in 1860 and established the Germania Life Insurance Company to offer insurance to other German immigrants.

Guardian merged with Berkshire Life in 2001 and increased its share of the disability insurance market.

It offers a large range of employer-offered insurance products, including life, health, dental and disability insurance which are governed by ERISA.

Guardian is a huge player in the individual disability insurance market and is a leader in offering graded premiums so the policy holder can purchase the level of insurance that suits their financial needs. It offers own occupation policies for professionals which is a rare offering these days. It also offers residual benefits coverage so that if you have suffered a loss of 15% of your pre-disability earnings, the policy holder can be paid a percentage of the difference. I think that Guardian and Northwest Mutual offer the best policies for professionals.

However, Guardian’s track record for claims handling is a different matter.

Guardian acquired the Reed Group in 2002 which offers an absence management program for employers to “manage” their disabled employees.  Reed Group offers a “tool” called “MD Guidelines” which is allegedly written by physicians and is a one size fits all “this is how long your employee or disability policy holder should be disabled” guideline.

In my personal opinion, Reed Group and MD Guidelines are in the business of managing disability claims for the sole purpose of denying, limiting and terminating benefits.

Guardian is no stranger to controversy. Guardian infamously canceled the health insurance plan that covered Ian Pearl, who suffers from muscular dystrophy and requires 24-hour nursing care that costs Guardian approximately 1 million dollars a year.

Guardian did not offer a comparable plan to replace the canceled health plan.  His parents called the cancellation a death sentence for Ian. The Pearl family sued Guardian and, during discovery, a Guardian memo that characterized policies like the one the Pearl family had as “dogs” and “train wrecks.”

Nonetheless, the federal judge found that Guardian had the right to terminate the entire plan and the Pearly family appealed to the Secretary of Health and Human Services and to the court of public opinion.

It was in the court of public opinion that the Pearl family won. Guardian apologized and reinstated Ian’s coverage and that of two other patients in similar circumstances.

I wonder if Hugo is spinning in his grave?

So, if Guardian canceled Ian’s coverage because it cost them too much, what do you think Guardian will do for you when you become disabled and apply for benefits?

How I Help Those With Guardian Insurance Policies ERISA Claims

The typical disputes with Guardian are the date of disability, claims for residual disability when the professional continues to work, the occupation the policy holder is performing when they became disabled, total disability and the coordination of the Guardian policy with other ID policies or ERISA group disability policies the policy holder may own.

That coordination is a key issue since many of my Guardian clients have more than one disability policies with different carriers. It is like untangling Christmas tree lights before you plug them in.

I have written the go to book for professionals called The Disability Insurance Survival Guide for Professionals.  You owe it to yourself and your family to get a copy of that book before you stop working and apply for benefits.   After all, you have spent hundreds of thousands of dollars in schooling and training and you need to know if you have adequately protected your career.

While you may work regularly with insurance companies, you are not an expert on disability insurance. In fact, fewer than 200 lawyers in the United States are what I would call an expert and I am one of them.

Guardian will:

  • Use in-house nurses to review medical records and reach medical conclusions about the policy-holders restrictions and limitations even though those nurses may have no training in or qualifications to render any opinions about the policy holders medical conditions,
  • Use biased medical peer review providers to create medical justifications for a claims denial so Guardian can claim that you are capable of performing the material and substantial duties of your occupation,
  • Use in house accountants to determine your pre-disability earnings and calculate your residual benefits, based on their analysis of your books, billings, and schedule,
  • Use surveillance companies to discredit the policy holders complaints,
  • Use any excuse to schedule a personal visit to your home to show you “Dancing with the Stars” video they have and give you the “we got you now” award that will result in a claims termination.
  • Use in-house vocational evaluators to misclassify your occupation and your ability to perform your occupation, perform questionable transferrable skills analysis and misinterpret the wages of and availability of other occupations it will claim the policy holder can do to justify the denial or termination of benefits.

Your claim is a very expensive claim and will cost them big bucks.  You are just another “Ian” and Guardian has nothing to lose!

ERISA Claims Lawyer For Guardian Disability Policies

You need an experienced disability insurance lawyer, like myself, who battles Guardian.

I will help you with your Guardian claim by:

  • Reviewing your policies,
  • Reviewing your medical records,
  • Create a pre-claim strategy to get your benefits on the initial application,
  • Appeal a wrongful denial or termination by writing an appeal letter 25 to 60 pages long that is the trial of your case and goes to Guardian inbox,
  • Protect you from aggressive claims handling, including the delay game, we need more information game, we want to take your statement game or we want to have you under an independent medical examination or FCE,
  • Aggressively litigating your case, if need be.

Don’t let Guardian treat you like Ian and delay, deny or terminate your benefits.