Guardian Must Rethink Benefits Claim After Delayed Doctor Report

Guardian Life Insurance Co. of America must rethink its decision terminating a former shipping supervisor’s disability benefits because it didn’t give him a chance to respond to medical reports supporting its decision, a federal judge ruled.

Federal regulations require disability plan administrators to give claimants any new or additional evidence considered in connection with their claim “sufficiently in advance” of the deadline for issuing a decision, along with a “reasonable opportunity to respond” to the evidence, Judge Roy K. Altman said.

Guardian flunked this standard by failing to produce peer review reports from a pair of doctors tapped to analyze ...