Denied by The Standard Insurance Company? We’re Champions for Folks Who Need Help.

1: Introduction: Understanding The Standard Insurance Company and the LTD Landscape

Summary: The Standard Insurance Company, founded in 1906 and now part of Meiji Yasuda Life, is a major player in the disability insurance industry, known for its strong financial ratings and expansive market reach. However, its claims handling has faced scrutiny, with legal actions and regulatory oversight highlighting potential challenges for claimants. This section introduces The Standard's history, market influence, and the often complex dynamic between its stated commitments and the real-world experiences of LTD claimants.

The Standard Insurance Company, commonly referred to as “The Standard”, has a long-established presence in the American insurance landscape. Founded in 1906 in Portland, Oregon, it became Standard Insurance Company in 1946 and steadily expanded to offer a broad range of insurance and retirement plan products, including both group and individual disability insurance (Short-Term Disability and Long-Term Disability).

A pivotal shift came in 2016 when its parent company, StanCorp Financial Group, was acquired by Meiji Yasuda Life Insurance Company, one of Japan’s largest and oldest life insurers. Since then, The Standard has expanded aggressively, acquiring Elevance Health’s Life & Disability business (adding roughly 4.8 million covered lives) and Allstate’s Employer Voluntary Benefits business (approximately 3.5 million customers). These acquisitions underscore a clear strategy to consolidate market share and grow its employer-sponsored disability benefits offerings.

Financially, The Standard is rated highly by independent agencies, with an A+ from Standard & Poor’s, A1 from Moody’s, and an A (Excellent) from A.M. Best—ratings it has reportedly maintained since 1928. These ratings highlight its financial stability and reliability as an insurer.

Despite this strong financial position and a public image centered on customer commitment—citing features like the waiver of premium for disabled policyholders—The Standard’s claims handling has drawn criticism and legal scrutiny. In 2017, it settled a class-action lawsuit for $2.4 million related to denied life insurance benefits for New Mexico public employees. Similarly, a 2016 multistate regulatory examination resulted in financial settlements and an agreement to reform certain life insurance practices.

For claimants navigating LTD claims, these legal and regulatory actions—along with numerous reported disputes—highlight a challenging dynamic: the tension between The Standard’s stated dedication to customers and the real-world struggles of claimants facing claim denials or delays. Understanding this backdrop is crucial for anyone seeking to secure disability benefits from The Standard.

If you’re already feeling overwhelmed by these complexities or have questions about your disability claim with The Standard, know that you’re not alone. In the following sections, we’ll break down the specific challenges and strategies that can help you protect your rights and secure the benefits you deserve.

2: Navigating The Standard Insurance Company LTD Claims: Common Challenges and Tactics

Summary: Navigating a long-term disability (LTD) claim with The Standard can feel daunting. From complex policy language to investigative tactics and procedural hurdles, understanding The Standard’s claim process and denial patterns is crucial for protecting your rights. This section unpacks common challenges claimants face and the insurer’s strategies.

Filing an LTD claim with The Standard Insurance Company often presents numerous obstacles. The process is shaped by policy-specific terms and, for many employer-sponsored group policies, the federal Employee Retirement Income Security Act (ERISA). This legal backdrop adds procedural layers that can trip up even the most diligent claimants.

Key Challenges and Insurer Tactics

✅ Complex Policy Definitions and Shifting Standards
One major challenge is the precise definition of “disability.” Policies typically start with an “own occupation” standard—meaning you’re disabled if you can’t perform the duties of your job. After a set period (often 24 months), the standard shifts to “any occupation,” requiring you to prove you’re unable to work in any role suited to your training or experience. The Standard’s interpretation of these terms can be strict, sometimes ignoring the nuances of a claimant’s actual job demands.

✅ Demand for “Objective” Medical Evidence
The Standard frequently cites a lack of “objective” evidence—like MRIs, X-rays, or lab tests—as grounds for denial. This poses significant hurdles for conditions like chronic pain, fibromyalgia, or mental health disorders, where subjective symptoms dominate. Claimants often face skepticism about their reports of fatigue, pain, or cognitive challenges.

✅ Policy Exclusions and Limitations
The Standard’s LTD policies often include exclusions for certain causes of disability (like felonies or self-inflicted injuries) and strict limitations on benefits for mental health conditions or “other limited conditions.” These limitations—sometimes capping benefits at 12 or 24 months—are common points of dispute, particularly when physical and mental health issues overlap.

✅ Pre-Existing Condition Investigations
If your disability arises soon after coverage begins, The Standard may investigate whether it stems from a pre-existing condition, using a “look-back” period of 3 to 12 months. Claimants frequently report extensive demands for past medical records, even when they don’t seem directly relevant.

✅ Scrutiny of Medical Care and Treatment
The Standard can deny claims based on gaps in care or perceived lack of appropriate specialist treatment. If your primary care physician is managing a complex condition without specialist involvement, it could be used as a reason to deny benefits.

✅ Use of Insurer-Selected Experts
The Standard often relies on doctors and vocational experts it hires to conduct “paper reviews,” independent medical exams (IMEs), or functional capacity evaluations (FCEs). These professionals may never meet you in person but can still provide opinions that conflict with your treating physician’s conclusions.

✅ Surveillance and Social Media Monitoring
The insurer may gather surveillance footage or monitor your social media accounts, looking for inconsistencies between your reported limitations and observed activities. This can lead to misunderstandings or misrepresentations of your condition.

✅ Procedural Hurdles
Strict ERISA and policy deadlines leave little room for error. The Standard rigorously enforces these deadlines, and missing one can result in the permanent loss of your claim. Coupled with often overwhelming information requests, these hurdles can be exhausting—especially for claimants already dealing with health challenges.

If you’re facing any of these challenges, you’re not alone. In the next sections, we’ll break down these issues in more detail—starting with the most common reasons The Standard denies LTD claims and how to respond.

2.1. Frequently Cited Reasons for LTD Claim Denials by The Standard Insurance Company

The Standard Insurance Company frequently cites specific reasons when denying Long-Term Disability (LTD) claims. These reasons often include demands for objective medical evidence, challenges to policy definitions of disability, and strict application of exclusions or limitations. Understanding these common denial grounds can help you proactively address them.

When The Standard issues an LTD claim denial, several patterns emerge. Here’s a breakdown of the most common reasons cited:

Insufficient Objective Medical Evidence

The most frequent basis for denial is The Standard’s demand for “objective” medical evidence—such as MRIs, X-rays, or lab test results—to confirm disability. This is particularly challenging for conditions like fibromyalgia, chronic fatigue syndrome, migraines, or mental health disorders that rely heavily on subjective symptom reports. The Standard may discount the opinions of your treating physician if they’re not backed by specific test results.

➡️ How Dorian Law Helps: We work to supplement your file with specialized testing (like FCEs and neuropsychological evaluations), obtain detailed physician reports linking symptoms to function, and craft legal arguments that challenge an overly narrow focus on “objective” data.

Not Meeting the Policy’s Definition of Disability

Policies define “disability” in precise terms—typically starting with an “own occupation” standard and transitioning to “any occupation” after a certain period. The Standard often denies claims by asserting that you do not meet this definition, sometimes applying broad interpretations of your job duties to argue that you can still work.

➡️ Our Approach: We conduct a detailed analysis of your job duties and medical limitations and may engage vocational experts to show how your condition prevents you from sustaining work under the policy’s terms.

Policy Exclusions and Limitations

Policies frequently contain exclusions (e.g., for disabilities related to felonies or self-inflicted injuries) and limitations for certain conditions. One major limitation The Standard applies is the 12 or 24-month cap on benefits for disabilities caused or contributed to by mental health conditions or “Other Limited Conditions” (like fibromyalgia and chronic fatigue). Disputes often arise when physical and mental health conditions overlap.

➡️ What We Do: We scrutinize policy language and medical records to challenge misapplications of these exclusions and limitations.

Pre-Existing Condition Exclusion

If your disability arises soon after your coverage begins, The Standard may investigate whether it’s linked to a pre-existing condition—often defined as any condition for which you received care or treatment during a “look-back” period. This can trigger demands for extensive medical history that feel intrusive and burdensome.

➡️ Our Role: We push back against misapplied exclusions and ensure that your medical history is accurately interpreted within the context of the policy.

Perceived Gaps or Inadequate Medical Care

The Standard may deny your claim if they believe there were gaps in your treatment or that you didn’t see the appropriate type of specialist. Reliance on a primary care physician alone for a complex condition may be deemed insufficient.

➡️ Our Guidance: We ensure your treatment history is robustly documented and help counter unreasonable expectations from the insurer.

Disagreements with Treating Physician’s Opinions

A common denial tactic involves The Standard relying on its own consultants—doctors, nurses, or vocational experts—who review your records but never examine you. These “paper reviews” often downplay or contradict the opinions of your treating physicians.

➡️ How We Counter: We highlight the treating relationship, obtain detailed rebuttals from your doctors, and challenge any flawed methodologies used by the insurer’s reviewers.

Surveillance and Social Media Evidence

The Standard may argue that your activities in surveillance footage or on social media contradict your disability claims. However, occasional or carefully managed activities don’t necessarily equate to work capacity.

➡️ Our Strategy: We contextualize this evidence and argue against misinterpretations, emphasizing that occasional activity is not equivalent to sustained work.

If any of these reasons resonate with what you’re experiencing, you’re not alone. In the next section, we’ll delve deeper into The Standard’s investigative and review tactics that often accompany these denials—and how to protect yourself.

2.2. Beyond the Denial Letter: The Standard Insurance Company’s Investigative and Review Tactics

The Standard Insurance Company uses a range of investigative and review tactics to evaluate—and often challenge—LTD claims. Understanding these tactics is key to anticipating potential hurdles and ensuring you’re fully prepared to protect your rights.

Even after an initial denial, The Standard’s efforts to scrutinize and challenge disability claims don’t end. The company uses various investigative and review methods that can feel intrusive and adversarial—especially for claimants already dealing with serious health issues.

Medical File Reviews (“Paper Reviews”)

The Standard relies heavily on internal staff or external medical professionals to review your medical records without ever meeting you. These “paper reviews” often prioritize certain data points that support a denial while ignoring or downplaying supportive evidence from treating physicians.

➡️ What to Watch: Paper reviews can appear authoritative but may lack context or nuance. They often conflict with your treating doctor’s conclusions.

Independent Medical Examinations (IMEs)

Most policies allow The Standard to require you to attend an IME with a physician they choose and pay for. While presented as an impartial assessment, these exams are often criticized for their brevity, lack of depth, and potential bias.

➡️ Key Tip: Attendance is usually mandatory—refusing can lead to automatic denial. It’s important to document everything about the IME and consider bringing a witness if allowed.

Functional Capacity Evaluations (FCEs)

FCEs involve physical testing by a therapist to measure what you can do—like lifting, carrying, sitting, and standing. The Standard uses FCE results to argue about your work capacity, but these tests often reflect maximum (not sustainable) effort.

➡️ Your Best Move: Ensure your treating physician understands the limitations of FCE data and can offer countervailing insights into your real-world work capacity.

Vocational Assessments and Transferable Skills Analysis (TSA)

The Standard may hire vocational experts to assess whether you can perform your “own occupation” or “any occupation.” These assessments often rely on national job databases like the Dictionary of Occupational Titles (DOT), which can be outdated and fail to account for your unique circumstances.

➡️ Why It Matters: These assessments can gloss over the practical barriers you face in today’s job market. Independent vocational assessments can be a powerful counterpoint.

Surveillance and Online Monitoring

The Standard may conduct video surveillance—especially near IME or FCE dates—to look for evidence that contradicts your reported limitations. They also monitor social media profiles for any posts or photos that might suggest higher activity levels than you’ve claimed.

➡️ Practical Guidance: Be cautious about public activities and social media presence. Occasional activity isn’t the same as sustained work capacity—but insurers often frame it that way.

Field Interviews and Home Visits

The Standard may send representatives to interview you at home. While these interviews are framed as “information gathering,” they also allow the insurer to observe your functional abilities and living situation.

➡️ Your Rights: You’re not required to agree to a home visit without consulting a lawyer. Be honest but concise if you participate.

Requests for Extensive Information

The Standard often demands a wide array of documentation—medical records, tax returns, detailed daily activity questionnaires, and more. These requests can feel overwhelming and repetitive.

➡️ Action Plan: Keep careful records of what you submit and be mindful of the scope of what you’re being asked to provide.

If you’re feeling the weight of these investigative tactics, know that you’re not alone. In the next section, we’ll look at the procedural hurdles and patterns in The Standard’s claims handling—factors that can make the entire process even more challenging for claimants.

2.3. Common Procedural Hurdles and Claim Handling Patterns

Beyond medical evidence and investigative tactics, The Standard’s procedural practices can create significant hurdles for LTD claimants. These include strict enforcement of deadlines, burdensome information requests, and delays in processing—all of which can place additional stress on already vulnerable individuals.

Procedural obstacles can feel as challenging as medical hurdles in an LTD claim with The Standard. Here’s what claimants commonly face:

Rigid Deadlines and Strict Compliance

The Standard enforces strict deadlines for filing claims, submitting medical updates, and appealing denials—deadlines often dictated by ERISA or policy language. Missing even a single deadline can lead to the permanent loss of your benefits.

➡️ What You Can Do: Treat every deadline as absolute. Submit documentation early, and if you need an extension, request it in writing before the deadline passes.

Overwhelming Information Requests

Claimants frequently report receiving repeated, broad, and sometimes duplicative requests for records and documents. These demands can include years of unrelated medical records, financial data, and detailed daily activity logs.

➡️ Our Guidance: Stay organized. Track every document you submit and keep a log of all correspondence with The Standard.

Communication Gaps and Inconsistent Responses

Many claimants experience poor communication—unreturned calls, conflicting information from different representatives, and a general sense of confusion about the claim’s status.

➡️ Why It Matters: Poor communication can leave you feeling powerless and unsure of your claim’s progress. Keeping a detailed communication log can help highlight issues if needed for an appeal.

Delays in Decision-Making

ERISA sets timelines for decisions (generally 45 days, with possible extensions to 105 days), but claimants often report waiting far longer for updates and final decisions. These delays can exacerbate financial stress and worsen the health crisis that triggered the claim.

➡️ How We Help: We ensure deadlines are enforced and can use delay-related violations as leverage in an appeal or potential litigation.

Potential ERISA Compliance Shortfalls

The Standard, like other insurers, must comply with ERISA’s procedural rules—such as providing full and fair review, sharing adverse evidence in time for the claimant to respond, and offering clear explanations for denials. When these standards aren’t met, it can strengthen a claimant’s case.

➡️ Strategic Angle: If The Standard fails to meet ERISA’s standards, courts may be more willing to overturn a denial—even under the deferential “arbitrary and capricious” review standard.

These procedural hurdles can feel overwhelming, especially when compounded by the health challenges you’re already facing. In the next section, we’ll dive into how The Standard’s approach can create unique difficulties based on your specific medical condition.

2.4. Specific Challenges Based on Medical Conditions

The Standard’s claims handling practices can be especially challenging for certain medical conditions. Whether your disability is related to mental health, chronic pain, or a condition with primarily subjective symptoms, understanding these unique hurdles is essential to building a successful LTD claim.

Certain medical conditions face heightened skepticism and unique hurdles when navigating a claim with The Standard. Here’s how these challenges typically play out:

Mental Health Conditions

Disabilities stemming from mental health issues—such as depression, anxiety, PTSD, or bipolar disorder—face dual challenges. First, many of The Standard’s group policies impose a 12- or 24-month benefit limitation on these conditions, even when the disability is severe and ongoing. Second, insurers like The Standard often demand “objective” evidence of mental health disability, which can be difficult given the inherently subjective nature of these conditions.

➡️ Key Point: Even when physical conditions overlap with mental health issues, The Standard may aggressively apply these limitations—leading to early termination of benefits.

Fibromyalgia, Chronic Fatigue Syndrome (CFS/ME), and Chronic Pain Syndromes

These conditions lack definitive “objective” diagnostic tests and rely heavily on patient-reported symptoms—like fatigue, pain, or cognitive difficulties. The Standard may challenge these claims using paper reviews, IMEs, or FCEs that minimize their impact and downplay treating physician reports.

➡️ Strategic Consideration: These conditions are often placed in the “Other Limited Conditions” category, subject to the same 12- or 24-month benefit caps as mental health conditions—making them especially vulnerable to early termination.

Conditions with Primarily Subjective Symptoms

Conditions like severe migraines, dizziness, and certain types of chronic back pain often rely on self-reported symptoms rather than objective test results. The Standard may treat these claims with particular skepticism, relying on surveillance or perceived inconsistencies in medical records to challenge your credibility.

➡️ What You Can Do: Work with your doctor to create detailed documentation that clearly explains how these symptoms limit your functional abilities.

“Own Occupation” Challenges for Professionals

Highly skilled professionals—like doctors, nurses, and lawyers—face unique difficulties under The Standard’s policies. The insurer may interpret the “own occupation” definition broadly, arguing that if you can perform any duties permissible under your license (like administrative tasks), you’re not considered disabled—even if you can no longer safely or effectively perform your actual job.

➡️ Why It Matters: This interpretation can create a significant hurdle for professionals whose roles rely heavily on specialized skills, not just licensing.

If you recognize your own struggles in any of these scenarios, know that you’re not alone—and that these challenges are well-documented. In the next section, we’ll explore the broader claimant experience: the real-world frustrations and hurdles reported by people dealing with The Standard.

3. The Claimant Experience: Reported Perspectives and Frustrations

Summary: Real-world experiences of claimants dealing with The Standard highlight common themes of frustration, financial hardship, and a perceived adversarial process. These insights can be crucial for understanding what to expect—and how to prepare—when pursuing a disability claim with The Standard.

Beyond policy language and investigative tactics, the claimant experience offers a powerful perspective on how The Standard’s claims process unfolds in practice. Reviews on platforms like Reddit, ConsumerAffairs, and the Better Business Bureau (BBB) reveal recurring frustrations.

3.1. Overview of Reported Sentiment

The dominant tone in these discussions is frustration and distrust. Many claimants describe feeling that the process is designed not to help, but to wear them down. They report feeling forced to constantly “prove” they’re disabled—even in the face of supportive medical evidence—and often describe the claims process as stressful and adversarial rather than supportive.

➡️ Notable Data Point: The Standard’s BBB profile shows 91 complaints filed in the last three years, with 38 closed in the past 12 months (as of early 2025). While the A+ BBB rating reflects responsiveness to complaints, it does not necessarily mean claimants are satisfied with the underlying outcomes.

3.2. Common Complaints from Claimants

Across multiple sources, several complaints come up again and again:

• Excessive Delays: Many report long wait times for initial decisions, appeal outcomes, and payments—often extending beyond regulatory deadlines.

• Communication Gaps: Difficulty reaching claims managers, unreturned calls or emails, and conflicting information from different representatives.

• Perceived Unfair Denials: Claimants feel that The Standard ignores treating physician opinions, relying instead on brief or biased reviews by insurer-selected experts.

• Burdensome Paperwork: Repeated and seemingly unnecessary requests for documentation, often feeling overwhelming or duplicative.

• Surprise SSDI Offsets: After receiving Social Security Disability Insurance (SSDI), some claimants are suddenly informed they owe substantial sums back to The Standard—leading to confusion and disputes over repayment amounts.

• Surveillance and Privacy Concerns: Awareness of surveillance or suspicion of being watched creates anxiety.

• Costly Appeals: The need to hire legal representation—often on a contingency basis—can lead to significant reductions in any eventual payout.

3.3. Impact on Claimants

The human impact of these challenges is profound. Financially, claimants describe depletion of savings, risk of eviction, and even bankruptcy. Emotionally, the stress of battling an insurer while managing health issues can worsen anxiety, depression, and a sense of hopelessness.

3.4. Specific Frustrations Often Mentioned

Several situations seem to consistently trigger complaints:

• STD to LTD Transition: Rather than a seamless move, claimants report new hurdles and paperwork that cause payment gaps.

• Change from “Own Occupation” to “Any Occupation”: Around the 24-month mark, claimants often face intensified reviews or terminations as the policy standard shifts.

• Pre-Existing Condition Investigations: Intrusive and broad information requests for past medical history—even when seemingly irrelevant.

• Challenges for Mental Health and Subjective Conditions: These claims face particular skepticism and are frequently denied or capped.

➡️ Key Insight: These patterns are not isolated complaints; they appear systemic, reflecting challenges inherent in The Standard’s LTD claims process.

If you see your own story reflected in these experiences, it’s important to know that there are strategies—and legal support—available to help you navigate and counter these obstacles. In the next section, we’ll take a closer look at how The Standard’s stated policies compare to the realities of these reported experiences.

4. The Standard Insurance Company’s Perspective: Stated Policies vs. Reality

Summary: The Standard Insurance Company publicly presents a well-structured, customer-focused approach to LTD claims. However, many claimants report a significant gap between this stated process and the real-world hurdles they encounter. Understanding this contrast can be critical for anticipating challenges and managing expectations.

The Standard’s official materials describe a supportive, transparent process for LTD claims. Their website, brochures, and policy documents outline a structured path to obtaining benefits, emphasizing fairness and financial protection.

4.1. Official LTD Policy Information

Key points highlighted in The Standard’s materials include:

• Income Replacement: Promises of replacing a significant portion of pre-disability earnings (typically 60–66⅔%) up to a policy-specific maximum.

• Reductions for Other Income: Benefits are reduced by other income sources, such as Social Security Disability, workers’ compensation, or state disability payments.

• Waiting Periods: Elimination periods (often 30–180 days) before benefits begin.

• Definitions of Disability: Policies use a two-tier definition—“own occupation” initially, transitioning to “any occupation” after a set period.

• Exclusions and Limitations: Specific conditions—like mental health issues or fibromyalgia—may be capped at 12 or 24 months.

• Additional Features: Depending on the plan, policies may include return-to-work incentives, rehabilitation support, survivor benefits, or cost-of-living adjustments (COLAs).

4.2. The Official Claims Process

The Standard outlines a seemingly straightforward process:

1️⃣ Report the Claim: Via online portal, phone, or paper forms.
2️⃣ Submit Required Forms: Including employee, employer, and doctor statements.
3️⃣ Claim Review: Analysts gather and review medical and employment records.
4️⃣ Communication: Decision notices sent by mail, with optional text updates.
5️⃣ Benefit Payments: Issued after the waiting period, typically monthly.
6️⃣ Return-to-Work Encouragement: Resources for transitioning back to work.

4.3. Juxtaposition: Stated Process vs. Experienced Hurdles

Despite these official promises, real-world claimants often face a different reality:

✅ Timeliness: Official timelines can be overshadowed by significant delays, with claimants waiting months for decisions or updates.
✅ Communication: The stated promise of proactive communication frequently contrasts with reports of unreturned calls and inconsistent information.
✅ Information Requests: While the forms appear straightforward, claimants describe an exhausting, duplicative documentation burden.
✅ Medical Evidence: The Standard’s heavy reliance on internal reviewers and IMEs often seems to overshadow treating physician evidence—despite official assurances of fair review.
✅ Policy Complexity: The fine print of limitations, exclusions, and changing definitions can be confusing—and exploited to deny or cut off claims.

➡️ Key Insight: This disconnect between The Standard’s stated policies and the lived experience of claimants may stem from operational pressures, risk management strategies, or both. Either way, it underscores the importance of vigilant preparation and—often—legal support to navigate the claims process.

If you’re grappling with the gap between what’s promised on paper and what you’re experiencing, you’re not alone. In the next section, we’ll explore how courts have weighed in on these disputes—and what those insights mean for your claim.

5. Judicial Review: Insights from Legal Battles Involving The Standard Insurance Company

Summary: When disputes over LTD claims with The Standard escalate, courts play a crucial role in resolving them. Federal ERISA law sets the rules for most group LTD claims, shaping how judges assess denials. This section highlights the legal standards, common issues, and important case examples that shape the litigation landscape.

Lawsuits against The Standard often arise when claimants believe their LTD benefits were wrongly denied or terminated. Understanding how courts view these disputes can offer important strategic insights for claimants.

ERISA Framework for LTD Claims

For most employer-sponsored LTD plans, the Employee Retirement Income Security Act of 1974 (ERISA) governs disputes. ERISA generally preempts state bad faith claims, requiring federal court litigation—decided by judges, not juries—and limiting evidence to what’s in the administrative record.

➡️ Critical Point: With few exceptions, courts don’t look at new evidence later in the process; they rely solely on what was submitted during the internal appeals process.

Key Standards of Judicial Review

✅ De Novo Review
If the LTD plan does not grant The Standard discretionary authority to interpret its own policy, the court reviews the case “anew,” considering all evidence in the record. This standard favors claimants.

✅ Arbitrary and Capricious (or Abuse of Discretion) Review
If the plan does grant The Standard discretion, courts defer to the insurer’s decision. A denial will be upheld unless the court finds it unreasonable or lacking substantial evidence. This standard significantly favors The Standard—unless there’s clear evidence of bias or serious procedural failings.

✅ Conflict of Interest
Because The Standard both decides claims and pays benefits, courts recognize a structural conflict of interest. While not enough to change the standard outright, this factor can sway courts if there’s evidence of biased decision-making.

Common Litigation Issues

• Medical Evidence Disputes: Courts frequently scrutinize whether The Standard gave proper weight to treating physicians versus insurer-hired reviewers.

• Policy Language Interpretation: Courts examine whether The Standard correctly applied policy definitions of disability, pre-existing condition clauses, and limitations.

• ERISA Violations: Lawsuits often allege The Standard failed to meet ERISA’s procedural requirements—like not providing adverse evidence or missing deadlines.

• State Law “Bad Faith” Claims: For individual policies not governed by ERISA, claimants may pursue these claims in state court.

Notable Cases Involving The Standard

• Zall v. Standard (7th Cir.): Found that The Standard violated ERISA’s “full and fair review” rule by failing to share an adverse consulting physician’s report before final denial—blocking the claimant from responding.

• Doe v. Standard (1st Cir.): Ruled The Standard acted arbitrarily by using a broad occupational standard (general lawyer vs. environmental lawyer) that didn’t match the claimant’s actual work.

• Kitterman v. Standard (D. Or.): Held that The Standard wrongly applied a mental health limitation to a claim where migraines contributed to depression, interpreting the policy term in the claimant’s favor.

➡️ Key Insight: These cases show that even under the deferential arbitrary and capricious standard, courts will overturn The Standard’s denials if there are procedural missteps, unreasonable interpretations, or evidence of conflict-driven bias.

If you’re in the midst of an appeal or contemplating litigation, these legal insights highlight just how critical it is to build a strong administrative record—and to challenge procedural errors when they arise. In the next section, we’ll explore unique factors that come into play when handling claims with The Standard.

6. Unique Aspects of Handling Claims with The Standard Insurance Company

Summary: While many disability insurers share common practices, The Standard Insurance Company has specific patterns and approaches that can significantly shape your LTD claim experience. Understanding these nuances is key to preparing an effective strategy for your claim.

Several characteristics make The Standard’s LTD claims handling distinctive—both in positive ways and in potential challenges for claimants.

Pronounced Emphasis on “Objective Evidence”

The Standard places especially high importance on objective medical testing—like MRIs, CT scans, and lab work—to confirm disability. This focus can create substantial hurdles for claimants with conditions primarily diagnosed through clinical evaluations and self-reported symptoms (such as fibromyalgia, chronic fatigue syndrome, or mental health conditions).

➡️ Implication: Without this “objective” data, claimants face an uphill battle to prove disability, even when their treating physician fully supports their claim.

Assertive Application of Policy Limitations

The Standard actively uses policy limitations, such as the 12- or 24-month benefit caps for mental/nervous conditions or “Other Limited Conditions.” These limitations are often central in disputes—especially in claims involving overlapping physical and mental health components.

➡️ What This Means: Claimants may need to challenge how The Standard classifies their condition to ensure it isn’t unfairly limited.

Potential for Strict Policy Interpretations

The Standard has been noted to apply narrow interpretations of key policy language. For instance, in “own occupation” cases involving licensed professionals (like doctors or lawyers), The Standard may argue that any licensed activity—regardless of job-specific skills—disqualifies a claim.

➡️ Practical Impact: Understanding this tendency is critical for professionals seeking to establish disability tied directly to their unique job demands.

ERISA-Centric Environment

As a major group disability insurer, most of The Standard’s claims are governed by ERISA. This framework imposes unique procedures and restricts how disputes can be litigated.

➡️ Key Takeaway: Navigating an ERISA claim demands specialized legal knowledge—different from traditional insurance bad faith claims in state courts.

Consistent Use of Investigative Tactics

Surveillance, IMEs, FCEs, and paper reviews are deeply embedded in The Standard’s claims approach. While not unique to them, the consistent use of these tools underscores their strategy to validate (or dispute) disability claims.

History of Regulatory Actions and Settlements

The Standard’s track record includes regulatory oversight and settlements related to claims handling practices. While not necessarily predictive of future conduct, these actions provide important context for understanding how the company has approached claims disputes in the past.

Impact of Corporate Transitions

The Standard’s 2016 acquisition by Meiji Yasuda and the more recent large-scale acquisitions of Elevance Health’s and Allstate’s benefits businesses may influence internal operations. Integrating large new portfolios can create transitional challenges or temporary inconsistencies in claims handling.

Concerns About an “Attrition Model”

Some legal experts and claimant advocates argue that The Standard—like other large insurers—may benefit from a process that pressures some claimants to abandon valid claims due to complexity, delay, or frustration.

➡️ Key Insight: Recognizing this dynamic can help claimants stay focused and seek the right legal help to overcome these pressures.

If you’re confronting any of these unique challenges with The Standard, it’s important to know you’re not powerless. In the next section, we’ll explore proactive strategies that can help you protect your rights and improve your chances of a successful claim outcome.

7. Strategies for Success When Dealing with The Standard Insurance Company

Summary: Winning an LTD claim with The Standard often requires more than just treatment provider certifications of disability—it demands a proactive, thorough, and strategic approach. Here’s how to prepare your claim, strengthen your file, and protect your rights against common denial tactics.

Given The Standard’s known practices and the complex ERISA framework, a smart, focused approach is essential for claimants. Here’s what can make a difference:

Understand Your Policy Inside and Out

Start by obtaining the complete Group Policy (and Summary Plan Description, if applicable) or the full individual policy. Carefully review:

• The definitions of disability—both “own occupation” and “any occupation.”

• The waiting period (elimination period) and maximum benefit amounts.

• Exclusions and limitations, including those for mental health or “Other Limited Conditions.”

• Pre-existing condition clauses and how they might apply.

• Deadlines for notice, proof of loss, and appeals.

➡️ Why It Matters: Many disputes stem from misunderstandings of the fine print—knowing your policy’s specifics can help you build a claim that addresses them head-on.

Build a Robust, Objective Medical Record

✅ Prioritize Objective Evidence: Gather all relevant objective tests—like imaging studies, lab results, or functional capacity evaluations—to support your claim.
✅ Specialist Care is Key: Make sure your treatment aligns with your condition—specialist care often carries more weight than primary care alone.
✅ Educate Your Doctors: Provide them with a copy of your policy’s definition of disability and ask them to write detailed narrative reports that address:

• Your diagnosis, with supporting clinical findings.

• How your symptoms limit your ability to work (quantify limitations where possible).

• Why you cannot sustain work in your “own occupation” or any occupation.

➡️ Pro Tip: Treating physicians’ opinions carry significant weight when they’re detailed and directly address your policy’s language.

Meticulous Organization and Deadline Management

✅ Track Everything: Keep detailed records of all submissions, correspondence, and phone calls with The Standard.
✅ Use a Calendar: Note every deadline and send required materials early—late submissions can jeopardize your entire claim.

Navigate The Standard’s Investigations Strategically

• IME/FCE Attendance: These exams are typically mandatory—attend, but document everything about the experience afterward.

• Surveillance Awareness: Be mindful of your activities in public and cautious about social media. Insurers can misinterpret isolated activities as signs of work capacity.

• Field Interviews: You have the right to consult an attorney before agreeing to a home interview.

Prepare for the ERISA Appeal Like Litigation

For group plans, your administrative appeal is your last chance to get new evidence into the record—it’s critical to go all-in.

✅ Submit Comprehensive Evidence: Address every reason for denial, include updated medical records, supportive witness statements, and any new expert opinions.
✅ Consult an ERISA Attorney: An experienced lawyer can craft legal arguments and ensure your record is as strong as possible.

Secure Independent Vocational and Medical Support

Don’t rely solely on The Standard’s hand-picked experts. Independent vocational evaluations and thorough, supportive medical reports can help level the playing field.

Manage SSDI Coordination Carefully

Many LTD policies, including The Standard’s, reduce benefits by SSDI payments. While The Standard may offer SSDI application help, consider using your own trusted SSDI attorney to avoid potential conflicts of interest.

Get Legal Support Early

The complexity of The Standard’s process—especially under ERISA—means that claimants who wait until after a denial to seek legal advice are often playing catch-up. The earlier you consult experienced counsel, the more effectively you can build a solid case.

These strategies are about taking back some control in a process that can feel overwhelming. In the next section, we’ll pull together these insights—along with how Dorian Law can help you turn them into a concrete action plan.

8. Conclusion: Securing Your The Standard Insurance Company LTD Benefits & How Dorian Law Can Help

Summary: Pursuing a Long-Term Disability claim with The Standard can feel like an uphill battle—especially when faced with procedural hurdles, insurer skepticism, and the complexities of ERISA. But you don’t have to do it alone. Dorian Law is here to help you level the playing field and secure the benefits you deserve.

Navigating a Long-Term Disability claim with The Standard requires more than just proving you’re disabled—it demands careful navigation of a complex system designed to protect the insurer’s bottom line. From strict policy definitions and investigative tactics to the procedural maze of ERISA, The Standard’s approach can leave even the most diligent claimants feeling frustrated and overwhelmed.

At Dorian Law, we understand how The Standard operates. We know the investigative tools they use, the legal nuances of ERISA, and the ways they interpret policy language to deny or cut off valid claims. Our role is to stand with you—to anticipate and counter their tactics, ensure your file is as strong as possible, and fight for your rights at every step.

How Dorian Law Supports You:

✅ Comprehensive Policy and Denial Review: We dig into the fine print of your policy and the insurer’s decision letters to pinpoint weaknesses in The Standard’s arguments.
✅ Evidence Development: We work directly with your treating physicians, coordinate independent evaluations, and gather the kind of robust, objective evidence The Standard demands.
✅ Full ERISA Appeals: We craft thorough administrative appeals that address every reason for denial—building the strongest possible record for potential federal litigation.
✅ Navigating Surveillance and Investigations: We advise you on handling IMEs, FCEs, and surveillance concerns, ensuring you don’t inadvertently harm your claim.
✅ Federal Litigation: If needed, we’re fully prepared to litigate your ERISA claim in federal court, using our experience to challenge The Standard’s practices and demand accountability.

Take Action Today

Don’t let The Standard’s complex process or aggressive tactics discourage you. The sooner you get experienced legal help, the stronger your chances of securing the benefits you’ve earned.

Contact Dorian Law today for a free case evaluation. Let’s work together to protect your rights and help you move forward.