Labor officers started speaking to Prudential about adjustments in group life declare procedures after a the division’s Worker Advantages Safety Administration discovered that Prudential had denied about 200 supplemental life claims, from 2017 by means of 2020, primarily based on allegations that group life plan members had failed to supply proof of insurability.
In some circumstances, officers mentioned, Prudential denied claims primarily based on lack of proof of insurability after insureds had been paying premiums since way back to 2004.
Labor officers say difficult a declare for lack of proof of insurability, after the insurer has had ample time to ask for the that proof, is improper.
“The Worker Advantages Safety Administration will take acceptable motion in opposition to any insurance coverage firm that collects common premium funds from plan members, and later performs a recreation of ‘gotcha’ to wrongfully deny advantages primarily based on technicalities like ‘insurability’ after the participant passes away,” Lisa Gomez, the assistant secretary accountable for the Worker Advantages Safety Administration, mentioned, in a remark included within the settlement announcement.
Eric Schwimmer, a Prudential Insurance coverage Co. of America vp, signed the settlement for Prudential.
“Constructive engagement with our regulators is a vital element of doing enterprise the precise approach, which is foundational to our strategy to delivering for our prospects, whereas fulfilling our regulatory obligations,” Prudential mentioned in assertion. “We’ve labored with the Division of Labor to resolve this matter. The impacted claims signify a really small subset of supplemental group life insurance coverage claims the place employers had collected premiums with out acquiring the required documentation. We’re addressing this with the small variety of supplemental group life insurance coverage prospects which can be impacted and proceed to supply clear steerage to our prospects concerning the tasks for sustaining proof of insurability going ahead.”
The U.S. Labor Division constructing in Washington. (Photograph: Mike Scarcella/ALM)