HOW TO APPEAL A METLIFE LONG-TERM DISABILITY DENIAL

Posted on July 3, 2019 by cjblog

As many as 25% of American workers will experience an unexpected illness or injury that will prevent them from working. In the event of a long-term disability, insurance policyholders expect their insurance coverage to be there as a financial support system. However, for people insured by Metropolitan Life (MetLife), that may not be the case. 

Unfortunately, large insurance companies like MetLife often employ unfair practices to deny legitimate disability claims and increase their revenues. Unfair or bad faith practices include asking for large amounts of paperwork, delaying decisions on a claim, trying to settle a claim for less than its value, or requesting exams by independent medical professionals. If you have received a MetLife long-term disability denial, there are things you can do to appeal the decision.

WHAT ARE BAD FAITH PRACTICES?

Insurance companies are required to provide benefits using good faith practices such as providing information about the application process, answering questions, and making decisions within a reasonable amount of time. Here are some of the bad faith practices you may encounter from MetLife or other big insurance companies:

  • Independent Medical Exams: While the insurance company has the right to ask for an independent exam, a bad faith practice would be sending an individual to a health care professional who is unqualified to assess your specific illness or injury.
  • Duplicate Documentation: You or your physician may receive multiple requests for documents you have already provided. Often the insurance company will claim the documents were lost or that they never received them. This is particularly troublesome if they repeatedly annoy your already busy physician.
  • Delaying Claim Decisions: You should be notified of a decision regarding your long-term disability claim within a reasonable amount of time. Check your policy, and if you receive insurance through your employer, check the ERISA rules for specific information.
  • Denying Your Condition Is Serious: An insurance company like MetLife may claim that your disability is not severe enough to qualify for benefits or that you have not provided enough medical evidence to support your claim.

Part of the reason that insurance companies employ these tactics is they count on policyholders to give up if they make receiving benefits too difficult. But remember: You have options. With the help of an LTD, you can appeal a denial and fight for your benefits.

UNDERSTANDING YOUR POLICY IS THE FIRST LINE OF DEFENSE

As a policyholder, make sure you are familiar with the terms of your policy. Read it carefully and thoroughly, especially the "small print." 
Be sure you understand how the insurance company defines disability, what benefits the policy will provide, and how long you may receive benefits. If you have questions you can contact the insurance company or check with a good disability attorney such as the lawyers at CJ Henry Law Firm LLC.

  • Definitions of Disability: Depending on your insurance policy, you may be considered disabled if you are unable to perform the duties associated with your current job. On the other hand, you may be considered disabled only if you cannot perform the duties of any occupation even if it is not your current job.
  • Duration of Your Policy: The cheapest disability insurance option may only provide benefits for a short duration. Avoid this option if you can. Look for a policy that will provide disability benefits for at least 5 years. The best option is a policy that will provide long-term disability benefits until you reach age 67.
  • Residual Benefits Option: If you can afford it, include residual benefits as an option to include in your long-term disability policy. This means you could receive benefits if you can only work part-time, which could be a significant decrease in your pay. If you do not have a residual benefits option on your policy, you will only qualify for benefits if you cannot work full-time.
  • Cost-of-Living Rider: This rider will ensure the payment amount of your benefits keeps pace with inflation and will protect you from losing money as the cost-of-living rises.

FILING A METLIFE LONG-TERM DISABILITY CLAIM

Filing a long-term disability claim with MetLife or any other insurance company can be daunting. Take your time and read all the information completely. In particular, make a note of any deadlines associated with your claim filing.

Be sure your medical records are up-to-date and that you have test results as well as written reports from your physician and other health care professionals you may see.

If you feel your disability claim has been denied unfairly, it's time to seek the assistance of an experienced disability lawyer.

CHALLENGING A METLIFE LONG-TERM DISABILITY DENIAL

CJ Henry Law Firm PLLC can review your claim and help you challenge a MetLife long-term disability denial. To speak to an Ocala FL long-term disability attorney, contact us today.

This entry was posted in Blog by cjblog.