If you or a loved one is a policyholder of MetLife disability insurance and your claim has been denied, you only have a limited time in which to act. Contact the nationally recognized law firm of Marc Whitehead & Associates without delay to schedule a free case evaluation with one of our long term disability benefits attorneys.
Experienced MetLife Disability Claims Denial & Appeal Attorneys
Marc Whitehead & Associates is a nationally recognized disability benefits law firm dedicated to protecting the rights of sick and injured workers who have had their disability claims unfairly denied or terminated by insurance companies like MetLife.
When you become disabled and need to claim disability income, you may find that your benefits are not always easy to obtain. We’ve guided thousands of clients all over the US through the complicated appeals process, enabling them to obtain the disability benefits they deserve. An active part of our practice is protecting MetLife policyholders when they have been wrongly denied disability income.
MetLife, One of the Largest Insurance Companies in the World
Founded over 140 years ago, MetLife (Metropolitan Life Insurance Company) has grown into one of the world’s largest providers of insurance products (including disability, life, dental, auto, home and long term care insurance), annuities and employee benefit programs, with over 90 million customers in over 60 countries.
MetLife sells both private individual disability insurance policies as well as short-term and long-term group employer disability benefits insurance policies. MetLife also acts as the administrator of group disability insurance plans.
Conflicts of Interest
Here’s something a lot of our clients don’t know: it’s common for insurance companies to both determine and pay benefit claims. This means that as a service of their group disability plans, MetLife acts as both the evaluator of the claim, and the payer of the claim. This dual role can lead to a serious conflict of interest. While such a conflict may serve the best interests of the insurance company, it often leaves the disabled claimant at a disadvantage.
MetLife disability claims denial involving group disability plans are governed by federal law known as The Employee Retirement Income Security Act of 1974, or ERISA. Most attorneys are not familiar with the nuances in ERISA governed claims and the limits it places on a claimant’s rights. Courts are confined – by law – to follow specific standards of review.
Under ERISA, a court may consider conflict of interest as a factor in a case; however, in most cases the presence of a conflict does not influence the outcome. What this means is, the court will generally uphold a denial of benefits unless the court finds that the administrator (insurance company) “abused its discretion.”
In a recent United States Supreme Court case – Metropolitan Life Insurance Co. v. Glenn 28 S.Ct. 2343 (2008) – the Court scrutinized MetLife’s role as both evaluator and payer of the claim in a recent case in which the insurance company denied a claim for long term disability. The Supreme Court ruled that MetLife’s actions went beyond the normal considerations of conflict of interest and ruled in favor of the disabled claimant.
Metropolitan Life v. Glenn
Wanda Glenn was employed at Sears when she suffered a disabling heart condition in 2000. Glenn applied for LTD benefits from MetLife through her Sears’ group employee disability benefits plan.
MetLife had both the discretionary authority to determine whether Glenn’s case was valid, and to act as the payer of the benefits. MetLife initially determined that Glenn could not perform the duties of her own job, and granted Glenn a 24-month disability benefit.
The company also told Glenn to apply for Social Security disability benefits. (Another common move by insurance companies) In 2002, the Social Security Administration ruled that Glenn was not only disabled from her “own” job, but also disabled from performing “any” job for which she was reasonably qualified.
Subsequently, Glenn was awarded permanent disability payments by the Social Security Administration retroactive to April 2000. Three-fourths of the Social Security benefits went to MetLife as an offset rather than to Glenn; the rest went to attorney fees.
Glenn then applied for MetLife long term disability. MetLife denied this claim, saying that her condition had improved to the point that she was no longer totally disabled – a decision at odds with that of the Social Security Administration, which found Glenn to be totally disabled.
Glenn challenged the MetLife disability claims denial in federal court. MetLife responded by arguing that it was entitled to the discretionary standard of review, as MetLife was entitled to discretion in making benefits determinations.
After reviewing the administrative record, the federal district court upheld MetLife’s denial of benefits. It found that “abuse of discretion” was the correct standard of review, and that MetLife had not abused this discretion.
Appealing the Decision
Glenn didn’t give up on her claim. She appealed to the U.S. Court of Appeals for the Sixth Circuit, which reversed the federal district court’s decision.
The Sixth Circuit Court of Appeals concluded that MetLife had a conflict of interest (MetLife both decides the claims and pays the claims) and that this conflict was a relevant factor in determining whether MetLife abused its discretion.
The Court ruled that MetLife had abused its discretion and ordered Glenn’s benefits to be paid by MetLife. The Sixth Circuit also factored in other serious concerns, including MetLife’s failure to consider the Social Security Administration’s determination that Glenn was totally disabled.
MetLife appealed to the Supreme Court. In June of 2008, in the case of Metropolitan Life Insurance Co. v. Glenn 28 S.Ct. 2343, the Supreme Court ruled against MetLife, affirming the decision of the Sixth Circuit Court of Appeals.
Changes to Come?
Hopefully, the court’s overturning of MetLife’s disability claims denial in this case may serve to improve the standards for review of ERISA disability claims, and positively affect future ERISA litigation. Going forward, any conflicts of interest will be given proper weight as a factor in finding abuse of discretion in a denial of LTD disability claims.
Of course, various Circuit Courts will deal with the impact of MetLife v. Glenn in different ways.
Ask for Experienced Help for MetLife Disability Claims Denial
Since various Courts will deal with the impact of MetLife v. Glenn in different ways, an in-depth understanding of ERISA law and the insurance industry is paramount when appealing an insurance company’s unfair denial of disability benefits.
If you believe that MetLife or another insurance company has wrongfully denied or terminated your long term disability insurance benefits, please contact the law offices of Marc Whitehead & Associates to schedule a free consultation to discuss your situation.
Marc Whitehead & Associates have successfully represented hundreds of MetLife policyholders in their efforts to appeal a denial of long term disability benefits. Unlike a lot of law firms, we possess the special resources and unique knowledge to fully prepare your ERISA appeal with the evidence you’ll need to overturn MetLife’s decision to deny your LTD benefits. We have a solid understanding of ERISA’s rules and regulations and how they affect your claim. We are with you every step of the way, even if it means filing a lawsuit in Federal Court to protect your rights.