Our attorneys have considerable experience appealing MassMutual disability income claim denials. We know how to effectively deal with this insurance provider. Contact Marc Whitehead & Associates now at 800-562-9830 to discuss your claim. Do not give in! We can assist you in any stage of the claim filing or appeals process.
Massachusetts Mutual Life Insurance Company (MassMutual) is based in Springfield, MA. The 160 year-old company sells various disability insurance plans. The company also markets annuities, retirement and long term care plans, and other financial products.
MassMutual has a large individual Disability Income (DI) insurance market. Many physicians, dentists, finance executives, business owners and other career individuals are MassMutual policy owners.
Other MassMutual policies are regulated by Federal ERISA law because they are part of an employee group benefits package.
For high earners who have group disability benefits through their employer, yet need additional coverage, MassMutual offers supplemental individual DI insurance. This supplemental insurance may be provided through the employer or professional association.
MassMutual is a “mutual” company, meaning it is owned by policyholders (not shareholders). Mutual companies are not publically traded, as a “stock company” would be. One purpose of being a mutual company is to guarantee its policyholders and members have a voice within the company, and confidence of long term access to their insurance benefits.
But like so many other insurance providers, MassMutual sometimes fails to pay disability insurance benefits on valid claims. If your MassMutual Disability income claim was denied or terminated unreasonably, our attorneys will help you take swift legal action to get the benefits you deserve.
Legal Issues with MassMutual Disability Income Claims
Like many insurers, MassMutual has engaged in various bad faith insurance actions, in order to be more profitable financially. These actions may include
- questioning your credibility (rather than disputing the facts)
- arbitrarily denying benefits under own-occupation disability policy
- repeatedly losing records and other claim-related documents you have sent to MassMutual
- claims handlers misinterpreting medical findings
- relying on policy language that is confusing and complex, making it difficult for you to meet MassMutual’s definition of “disabled”
- using third party medical exams to override or dismiss your treating physician’s records and opinions
- wrongly classifying your complex physical disorder as a mental / nervous condition – drastically reducing benefit payments to 24 months or less
- various other methods in which the company does not give your claim a fair and objective claim review, to further in their own financial interests.
Why MassMutual May Deny Your LTD Claim
Many people with LTD insurance will never need the coverage. However, the relative minority of policyholders who find themselves permanently disabled and unable to work often find their claims denied. MassMutual may deny your LTD claim for several reasons, but the primary one is that the insurer is more focused on collecting your monthly premiums than providing benefits.
Moreover, the insurance company will deny your claim if it believes that your disability does not fit MassMutual’s policy definition–or that your disability does not prevent you from working. Some reasons associated with claim denial refer to mistakes or omissions on the patient’s part, while others involve the insurer’s attempt to limit benefits.
Common reasons for MassMutual denying an LTD claim include:
- Paperwork errors–It is critical that all forms are filled out correctly to avoid denial.
- Insufficient medical evidence–In the insurer’s view, the medical evidence submitted does not prove you have a disability that prevents you from working.
- MassMutual doctors determine you are not disabled–Insurers frequently demand an Independent Medical Evaluation (IME) conducted by an “independent” doctor who works for them. It is not surprising that this IME may contradict the findings of your physicians.
- Occupation coverage–After 24 to 48 months, your own occupation coverage changes to any occupation. That means that while you may have been unable to work in your former job due to your disability, you must show MassMutual that you cannot hold any position.
- Surveillance video–Insurance companies have employees who check social media pages for evidence that people are dishonest about their disability. For example, insurers may have investigators stake out your home, waiting to take videos or photos of you lifting heavy items–including toddlers or grocery bags–that you are supposedly incapable of doing. Avoid posting anything on social media that could be used against you.
- Suspicion of working side gigs–In its quest to show that an applicant can work, MassMutual will look for evidence that you are engaging in side gigs outside your primary job.
Remember that a denial letter is not the end of the story. You have the right to file an appeal of your denial within 180 days of receiving their notification. Contact us as soon as possible after receiving your MassMutual denial letter.
MassMutual Disability Claim Attorneys
Marc Whitehead & Associates law firm is dedicated to helping insureds overturn unfairly denied short term and long term disability benefits. We offer a free consultation to discuss your claim and how we may be able to assist you.
Whether you are a self-insured professional, or your group insurance coverage is offered through your job – if MassMutual wrongly withheld or terminated your insurance benefits, contact our law firm.
