Posted Sep 17, 2007 01:31 pm CDT
An insurance company’s aggressive surveillance of an injured woman has led a federal appeals court to reopen the insurer’s decision to cut off disability benefits.
Hartford Insurance Co. continued the surveillance even though it had turned up no evidence of fraud, the Legal Intelligencer reports in its story on the decision (PDF). Partly as a result of that tactic, the insurer’s benefits decision deserved “heightened scrutiny,” the Philadelphia-based 3rd U.S. Circuit Court of Appeals ruled.
The story says the decision is important for insurers handling ERISA cases because it expands on an earlier 3rd Circuit decision that sets out when courts may apply “heightened arbitrary and capricious review” to insurers’ benefits decisions.