Friday, September 16, 2016


When Prudential was forced to conclude that a long term disability (“LTD”) claimant lacked full time work capacity and had reached maximum medical capacity, it transferred that claim to its Mature Claim Team (“MCT”). The MCT was the place for claims where Prudential recognized it was liable for having to pay LTD benefits for the maximum duration under Prudential’s LTD policies. Since MCT claims involved claimants with permanent or progressive medical conditions, as a cost saving measure, Prudential’s procedures required that MCT claims be reviewed less often. 

I am currently litigating two cases in federal court with Prudential. Both plaintiffs have permanent and progressive medical conditions, and were paid LTD benefits for over a decade. Prudential had concluded that both plaintiffs lacked full time work capacity and had reached maximum medical improvement. Consequently, Prudential transferred each plaintiff’s claims to Prudential’s MCT. 
Even though Prudential had determined that each plaintiff had medical problems that had reached maximum medical improvement, and therefore, would never change for the better, in 2014, Prudential decided that it needed each plaintiff’s doctors to explain why their patients remained disabled. After each of the plaintiff’s doctors did so, Prudential then had its own doctors reject the opinions of each plaintiff’s doctors in order to conclude that the plaintiffs were no longer disabled. In both cases, Prudential failed to identify any medical test or exam finding that had changed between the time Prudential found the plaintiffs disabled and no longer disabled. 

The similarities between the two cases are obviously no coincidence. Prudential made the business decision to invade the MCT in 2014 in order to increase its profitability by reducing those MCT reserves. Its strategy was to get the treating doctors to say the claimants had work capacity, and if the doctors refused to buy into that argument, then Prudential would have its doctors reject the opinions of the treating doctors. 

If Prudential terminated your LTD benefits, demand a copy of your claim file. Check to see if your file contains references about Prudential transferring your claim to its MCT or TRT. Also, check to see if your file contains references to NC/M, which means Prudential determined that you lack work capacity and have reached maximum medical improvement, which might be abbreviated as MMI. I would appreciate hearing if you were subjected to this particular bad faith practice and pattern of Prudential’s.

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