How Guardian Life Handles Disability Claims
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 policyholder 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 suffered from muscular dystrophy and required 24-hour nursing care that cost 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. Could Hugo be 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?
- 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 policyholder’s medical conditions,
- Use biased medical peer review providers to create medical justifications for a claim’s 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 policyholders’ 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 claim’s 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 policyholder 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!