Facing a MetLife long-term disability (LTD) insurance claim denial can be difficult to swallow. Insurance companies like MetLife are known for rejecting legitimate claims, often citing policy exclusions or invalid reasons. Determining the applicability of each case can be a challenge for individuals. Some find themselves entangled in a futile struggle against an insurmountable claim, while others may prematurely abandon their pursuit, even when their claim is substantiated and can be proven.
Insurance disputes are complex, and understanding why MetLife denied your claim is crucial to building a compelling appeal. At Kantor & Kantor, we understand the significance of securing the benefits you depend on for financial stability during difficult times. Our legal team is well-versed in the intricacies of MetLife’s denial practices, and we are here to unravel the intricacies of your case, offering clarity and a strategic approach to securing the benefits you rightfully deserve.
If you’ve submitted a claim for LTD benefits with MetLife and have been denied, there are strategic actions you can take during the appeal process to strengthen your case. While it is possible to manage the appeal alone, enlisting the help of a MetLife LTD insurance denial attorney can prove advantageous, particularly since appeals often represent the final opportunity to introduce compelling evidence into your record before its closure.
We are people helping people, and our LTD insurance lawyers have experience navigating appeals with MetLife. Contact us at 818-886-2525 for a free consultation.
We offer a free case evaluation to discuss how our attorneys can assist you. Contact us now at 818-886-2525 for a free consultation.
What Is MetLife Disability Insurance?
Established in 1868 as the Metropolitan Life Insurance Company, MetLife stands as a venerable institution in the world of insurance. The company boasts a vast clientele of 90 million customers across 60 countries and is publicly traded on the New York Stock Exchange. Despite its longstanding reputation, MetLife has garnered a notable track record of denying claims, particularly in LTD policies.
MetLife and its affiliated companies collect billions of dollars in premiums annually from ordinary working Americans. These individuals willingly contribute their hard-earned money with the expectation that, in the event of an illness or disability, they will receive the promised protection. Regrettably, this expectation is frequently unmet. Once deemed trustworthy, the insurance company often employs various tactics and exploits loopholes to either prolong the process of compensating you or, in some cases, outright deny your rightful payment.
If you have been denied or are contemplating filing a claim, securing a comprehensive copy of the policy is essential. Check the intricacies outlined in the policy’s fine print and subsequently consult a MetLife LTD insurance denial attorney to evaluate your options.
Unfair Tactics Used by MetLife to Deny Insurance Claims
MetLife may employ various tactics to deny or delay legitimate claims. These tactics can include:
- Using in-house nursing staff to review and deny intricate medical claims could result in a lack of impartiality and a skewed assessment.
- Engaging doctors whose primary client base consists of insurance companies raises concerns about conflicts of interest and potential bias in favor of the insurer.
- Exhibiting contentious behavior toward policyholders filing claims related to mental health or nervous conditions potentially aggravates an already challenging situation for claimants.
- Distributing incomplete paperwork to doctors involved in the claims process is a tactic that hinders them from providing accurate or comprehensive opinions on the claimant’s condition.
These past practices reflect a pattern of behavior that may impact the fairness and thoroughness of the claims evaluation process. It is advisable for individuals navigating such situations to be aware of these potential challenges and seek professional guidance from a MetLife LTD claim denials attorney.
Why Did MetLife Deny Your LTD Insurance Claim?
MetLife, like any insurance company, may deny claims for various reasons. Understanding the specific grounds for denial is essential in building a strong case for appeal. Common reasons for denials include:
1. Requests for Independent Medical Examinations (IME) by Under-Qualified Medical Professionals
MetLife may request an IME as part of the claims review process. However, there are instances where the chosen medical professionals may lack the expertise relevant to your condition. This can result in an inaccurate assessment of your medical condition, leading to a denial based on incomplete or biased information.
2. Multiple Requests for Duplicate Information
Repetitive requests for the same information can be a frustrating and time-consuming aspect of the claims process. MetLife may use this tactic to create delays or confusion, making it challenging for claimants to meet their demands.
3. Taking Longer to Make a Decision Than Is Allowed by Law
Insurance companies are typically bound by specific timelines for processing claims. Delays beyond these legally mandated time frames wear down claimants and discourage them from pursuing their rightful benefits. If MetLife exceeds the legally mandated time frame, it can be a basis for challenging the denial.
4. Failing to Consider All of the Evidence You Submit
A thorough consideration of all evidence is crucial for a fair assessment of your claim. MetLife’s failure to consider relevant medical records, expert opinions, or other pertinent evidence can contribute to an unjust denial.
5. Requests to Settle the Claim for Less Money
MetLife may attempt to settle your claim for an amount that does not accurately reflect the full value of your entitlements. Such negotiations may be conducted without due consideration for the extent of your disability and its financial impact on your life.
6. Refusal to Render a Decision in a Reasonable Amount of Time
Protracted delays in rendering a decision can cause financial hardship and emotional distress. MetLife’s unwillingness to expedite the process may be deliberate, aimed at discouraging claimants from pursuing their rightful benefits.
7. Minimizing Medical Evidence That Supports Your Claim
MetLife may downplay or disregard medical evidence that strongly supports your disability claim. This can be a deliberate strategy to weaken the foundation of your case.
Why Choose Kantor & Kantor?
Choosing the right legal representation can make all the difference when challenging a MetLife LTD claim denial. Here are some compelling reasons to choose Kantor & Kantor as your lawyers for MetLife LTD insurance claim denials.
- Expertise in Insurance Law: Our legal team focuses on insurance law, with emphasis on LTD claims. This allows us to stay at the forefront of industry developments, ensuring that we are well-equipped to navigate the intricate details of your MetLife LTD claim.
- Track Record: We have a track record of handling insurance denials, including those involving MetLife. Our lawyers have secured favorable outcomes for clients facing claim denials, establishing a reputation for effective advocacy and positive results.
- Personalized Approach: We understand that every case is unique and take a personalized approach to each client’s situation. Our attorneys invest the time to thoroughly understand the details of your case, allowing us to tailor our strategies to meet your needs and challenges.
- Comprehensive Understanding of MetLife Policies: Like many insurance providers, MetLife has intricate policy provisions that can be challenging to interpret. Our team has an in-depth understanding of MetLife’s policies and the nuances that may lead to claim denials. This knowledge enables us to pinpoint weaknesses in the denial and craft compelling arguments for your appeal.
- Effective Communication: We prioritize clear and transparent communication throughout the legal process. Our team will keep you informed at every stage, explaining complex legal concepts and providing realistic expectations for the progression of your case.
- Aggressive Advocacy: Facing a denial from a large insurance company like MetLife requires assertive and strategic legal representation. We are known for our aggressive advocacy for clients, challenging unfair practices, and tirelessly pursuing the benefits you are entitled to.
- Resources and Network: Our law firm has access to a network of experts, medical professionals, and resources that can strengthen your case. We leverage these connections to build a comprehensive and compelling appeal, ensuring that all aspects of your claim are thoroughly examined.
A History of Winning Cases Against MetLife
We have a history of success against MetLife in various legal settings. Our legal victories include cases where MetLife’s denial tactics were rigorously contested and we emerged triumphant. These successes illustrate our prowess in dismantling MetLife’s defense strategies and advocating effectively for our clients. Here are some cases we have won against MetLife:
- Dowdy v. Metropolitan Life Insurance Company, 890 F.3d 802, (9th Cir. 2018)
- Jahn-Derian v. Metropolitan Life Insurance Co., 2016 WL 1355625, (USDC C.D. CA 2016)
- Bledsoe v. Metropolitan Life Ins., 90 F.Supp.3d 901, (USDC C. D. CA 2016)
- Dine v. Metropolitan Life Ins. Co., 449 Fed.Appx. 646 (9th Cir. 2011)
- Mitchell v. CB Richard Ellis Long Term Disability Plan, 611 F.3d 1192 (9th Cir. 2010)
- Toven v. Metropolitan Life Ins. Co. 2009 WL 578538 (USDC 2009)
- Kolano v. Metropolitan Life Ins. Co. 280 Fed.Appx. 674 (9th Cir. 2008).
If MetLife has denied your LTD insurance claim, contact Kantor & Kantor Insurance claim denials attorney today for assistance.
Appealing a MetLife Disability Claim Denial
There are two main avenues for challenging a denial of disability benefits, depending on whether your disability insurance falls under ERISA coverage. If your employer provides the insurance, it is typically governed by ERISA, while individual plans can be appealed outside ERISA.
ERISA mandates specific procedures for insurance companies when denying or terminating a claim. These procedures include issuing a detailed denial notice, specifying the policy basis for the denial, informing you of your rights, providing the rules used in the denial, and outlining the appeals process. Federal law dictates that you must file an appeal with the insurer before pursuing legal action.
If your appeal is rejected, you may file a lawsuit against the insurance company in federal court. A lawyer for MetLife LTD claim denials can assist in initiating the appeal and representing you in the lawsuit, improving the chances of a successful outcome.
For plans not covered by ERISA, there is typically a defined time frame for appealing a denial. If your appeal is unsuccessful, you can file a lawsuit against the insurer in state court, often arguing bad faith on the part of the insurance company in denying your claim or terminating your benefits.
How Do I Appeal a Denied MetLife LTD Claim?
When pursuing an appeal for LTD benefits, gathering additional evidence that reinforces any weaknesses in your initial claim and bolsters existing supporting information is crucial. In court, the strength of your case will largely depend on the evidence submitted during the appeal process.
By focusing on and strengthening these specific areas, you can reduce MetLife’s grounds for potential future denials. Here are several strategic steps that can be taken during the appeal process:
1. Correct Errors in Initial Claim
If your initial application was rejected due to inaccuracies or missing information, the appeal provides an opportunity to rectify these issues. Thoroughly review your application, ensuring that any amendments align with the insurer’s requirements.
2. Request a Report from Treating Physician
A detailed report from your treating physician can complement existing medical records, offering a more comprehensive understanding of your disabling condition. Honest communication with your doctor is crucial to ensure a thorough assessment of how specific symptoms impact your daily life.
3. Impact Statements from Personal Acquaintances
Testimonies from family, friends, and coworkers who have observed the effects of your medical condition on both personal and professional aspects of your life can serve as powerful evidence. These statements provide an external perspective on the impairment caused by your disability.
4. Seek Expert Opinions
Insurance companies, including MetLife, often enlist their experts to assess claims. To counter potential bias, consider obtaining opinions from impartial experts who can independently evaluate your occupation or conduct additional medical examinations. The outcomes of these assessments can significantly strengthen your claim.
How We Can Help With Your Case
Here is how our MetLife LTD denial attorneys can help with your insurance claim denial.
- Thorough Case Evaluation: Our legal team begins by thoroughly evaluating your case. We meticulously review all relevant documents, including your insurance policy, medical records, and the denial letter. This comprehensive assessment allows us to identify discrepancies, errors, or missing information that may have led to the denial.
- Building a Strong Appeal: Armed with a detailed understanding of your case, we work to build a strong and persuasive appeal. This involves addressing the specific reasons for the denial, presenting additional evidence, and providing legal arguments highlighting your claim’s validity. We leverage our expertise to anticipate and counter any potential challenges that may arise during the appeal process.
- Engaging with Medical Professionals: In many disability cases, medical evidence plays a critical role. We collaborate with health care professionals and medical experts to ensure your condition is documented and supported by credible opinions. This collaborative approach strengthens the medical foundation of your case, reinforcing the legitimacy of your claim.
- Negotiating with MetLife: Our experienced negotiators engage with MetLife on your behalf, seeking a fair resolution before resorting to formal legal proceedings. We aim to reach a settlement that secures the benefits you are entitled to without unnecessary delays. We are prepared to escalate the matter to formal legal channels if negotiations prove unsuccessful.
- Litigation if Necessary: Our experienced litigators are well-versed in insurance litigation, and we approach each case with tenacity and determination. Our courtroom experience enables us to present a compelling case and advocate vigorously for your rights in a legal setting.
Our attorneys at Kantor & Kantor will help you gather all medical records and other documentation to help you fight your MetLife Insurance claim denial.
Contact Kantor & Kantor to Help With a MetLife LTD Insurance Claim Denial Today
If you have received a denial from MetLife regarding your LTD insurance claim, do not hesitate to contact Kantor & Kantor. We are people helping people, and our experienced attorneys are ready to assess your case, provide personalized guidance, and fight for the benefits you deserve. Contact us today at 818-886-2525 for a free consultation and take the first step toward securing your financial well-being.
Attorney Glenn R. Kantor
Glenn Kantor is a founding partner of Kantor & Kantor LLP. As a young attorney, Glenn saw the injustice of wrongful insurance denials and created a law firm to represent individuals seeking to obtain their rightful benefits. Glenn is committed to ensure that clients receive the benefits they are entitled to under their insurance policies or group health plans. [Attorney Bio]
