MetLife Long-Term Disability Denial
Metlife is among the largest providers for long-term disability insurance. Each year, millions of Americans purchase MetLife long-term disability policies to cover them in the event that they are no longer able to perform the duties that their job requires of them. A large percentage of these claims are denied for reasons that don’t make a lot of sense to them. At Robinson & Warncke, we work hard to protect your investment and help ensure your policy pays out when you need it the most.
How Does the MetLife Claims Process Work?
Understanding how the claims process works can help you avoid serious problems in your claim. Insurance companies are well-known for denying valid claims — but sometimes, denials are based on policy exclusions or for otherwise valid reasons. Most people aren’t sure which applies in their case. In some cases, they fight a hopeless battle against a claim that cannot be satisfied. In other cases, they give up even when their claim is provable. Robinson & Warncke can help you analyze your claim and determine whether or not it’s worth pursuing.
MetLife offers both long- and short-term disability policies. Short-term policies provide benefits for between three months and one year. Long-term policies provide benefits indefinitely. That being said, there is an elimination period. The terms of the policy may stipulate that after a certain period of time has elapsed, you must prove that you can’t work any job (as opposed to your current job) in order to continue receiving benefits.
As a policyholder, you must understand the definition of disability in your policy. An insurer’s definition tends to be far narrower than the average person’s. In some policies, you will be considered disabled if you can no longer perform the duties of your current job. In other policies, you will only be considered disabled if you can no longer perform the duties of any job (for which you are qualified and provides you with a similar standard of living). The majority of policies provide a certain period of own-occupation coverage then morphing into an any-occupation coverage policy.
An experienced disability attorney can read over the fine print of your policy and help you determine if moving forward with fighting a denial is in your best interests.
Why MetLife Denies Claims
It’s no secret that insurance companies make money by denying claims. What flies under the radar is that they also make money by delaying claims. Giving policyholders the runaround has thus become a standard operating procedure for major insurance providers like MetLife. If you feel that MetLife has unfairly denied or delayed your claim, you should contact an Atlanta, GA disability lawyer immediately.
Common red flags indicating your claim is not being processed fairly include the following:
- Requests for independent medical examinations (IMEs) by under-qualified medical professionals;
- Multiple requests for duplicate information;
- Requests to settle the claim for less money than it’s worth;
- Unwillingness to render a decision in a reasonable amount of time; and,
- Minimizing medical evidence that supports your claim.
Why does this work? Because some policyholders don’t fight back. Long-term disability policies pay out large sums of money across several years. If it works even 10% of the time, then that’s more money in the company’s coffers.
Unfair MetLife Long-Term Disability Denial Tactics
While it’s typical for insurance companies to request more information following an initial claim, MetLife is known to provide ambiguous or misleading information in regards to what information they require to complete the claims process. Additionally, they incentivize their independent medical examiners to minimize your injuries and subsequently deny your claim. Lastly, they fail to consider the duties of your individual job when denying your claim. In other words, they will claim that you can still do your job with your disability based on a false description of your job.
In the past, MetLife has:
- Used in-house nursing staff to review and deny complex medical claims;
- Elicited the aid of doctors whose primary clientele is insurance companies;
- Antagonized or sought to aggravate policyholders seeking claims for mental health or nervous conditions;
- Sent doctors incomplete paperwork preventing the doctor from giving an accurate or complete opinion on the claimant.
MetLife’s Use of Surveillance to Deny Disability Claims
MetLife is a very large company with nearly unlimited resources. They can certainly outspend anyone who attempts to make a claim on their policy. Big insurance companies like Metlife are known for performing background checks on claimants, scouring their social media accounts, and even sending private investigators to snap photos of claimants doing things that compromise their claim.
We Can Help You Appeal a Denial
MetLife counts on the fact that many of their policyholders will not fight a denial. If even one policyholder gives up before their appeals are exhausted, the company has saved themselves thousands of dollars. Now consider the fact that the number of policyholders that give up once they’re denied coverage is closer to 25% to 50%. They assume that those who are willing to fight back “really need” their disability coverage.
Having an attorney manage your claim lets MetLife know that you’re serious about getting the benefits you deserve. If your claim is being stalled or denied, we may be able to file a motion to prove that MetLife is acting in bad faith. Our job is to make sure that your claim is processed honestly and that the insurer upholds their end of the bargain.
We will go through your medical records, read every line of the policy, and ensure that the courts understand what your work duties are. We can help you create a strong case file that MetLife can’t easily deny.
To learn more about appeals, read our article Should I Handle My Own Appeal?
Robinson & Warncke Can Help You Fight a MetLife Long-Term Disability Denial
If you received a MetLife long-term disability denial, don’t be intimidated. MetLife banks on policyholders giving up early in the process. Robinson & Warncke can help you continue to file paperwork with the insurance company and ensure that they don’t get away with bad faith practices. Contact us today to learn more.