If you are insured with Massachusetts Mutual Life Insurance Company, better known as Mass Mutual, then you may have long-term disability benefits as part of a group plan offered by your employer. However, most group plans only pay you 60% of your pre-disability earnings. In order to bridge the income gap between your true wages and your group benefits, you may have purchased individual disability insurance (DI) plan.
Mass Mutual offers both group and individual disability insurance policies, and actually has a pretty accurate video of why individual disability insurance benefits are so important:
Long-term disability (LTD) benefits are supposed to replace your wages in the event that you become disabled and unable to work. When you file a disability insurance claim with Mass Mutual, you expect to receive an approval letter along with the benefits you were promised when you signed up for benefits. Unfortunately, it is much more likely that you will receive a Mass Mutual disability denial letter instead.
Can You Be Denied Disability Insurance?
Unfortunately, long-term disability insurance companies like Mass Mutual often do not pay out the benefits they should. Sometimes a disability insurance claim is denied from the start. Sometimes disability income benefits are terminated prematurely, although the claim was initially approved. However, there are steps you can take if your claim is wrongfully denied or terminated. You have the right to file an appeal, which might enable you to obtain the benefits you deserve.
Mass Mutual Long Term Disability Insurance Claims Are Often Denied
Types of Issues in a Mass Mutual Disability Claim
As a disability insurance attorney, Nick A. Ortiz has represented numerous clients with their long-term disability claims against insurance companies like Mass Mutual. If you’ve found this page, you are probably a disability claimant in need of professional legal services in connection with a long term disability insurance policy or disability income policy purchased from Mass Mutual, including one of the following:
- An ERISA appeal of a Mass Mutual denial of long-term disability benefits;
- A non-ERISA appeal of a Mass Mutual disability denial;
- A lawsuit against Mass Mutual for the wrongful denial of long-term disability claim; and/or
- A lump-sum buyout offer of a Mass Mutual long-term disability insurance policy.
It is important to seek legal advice as swiftly as possible to preserve your options, as you may only have a limited time to submit an appeal, file a lawsuit, or respond to a lump-sum buyout offer. Disability insurance lawyers can also help you determine whether your claim is governed by ERISA disability law or not. Most group disability policies are governed by ERISA.
Why Would My Long Term Disability be Denied?
Mass Mutual’s disability insurance policy will require that you meet the definition of disability as defined in the policy. If you don’t meet that description, you will receive a denial letter that explains the reasons your disability claim does not satisfy the definition of disability, usually by e-mail or mail.
Most Mass Mutual claims are denied as a result of the medical records or doctor’s accounts to are submitted to support the claim. It can be the result of a discrepancy in your medical records, or Mass Mutual may have your claim reviewed by a different, independent doctor.
Your claim could also be denied as a result of surveillance. Mass Mutual will look into your social media accounts, and they might even hire a private investigator to conduct video surveillance of your daily activities. If the surveillance shows that you are performing activities that contradict the limitations reported in your medical records, Mass Mutual will attack your credibility to support their claim denial.
Another common reason for receiving a denial is not providing timely notice to his/her claimer. This is a technical issue, not a substantive issue with your claims, but it can still prevent a claim approval. Claimants should be mindful of this when they are considering filing a claim.
It Is Important to Take Immediate Action to Preserve Your Rights
Appeals
The denial letter will explain the steps to move forward with the appeal process as well as the time frame you have for filing an appeal. Many insurance policies allow claimants 180 days to submit an appeal, but we have also seen time frames as short as 60 days. This may seem like a long time, but gathering the medical evidence you need to support your disability claim can be a lengthy, exhausting process. Disability attorneys can assist you in gathering the medical evidence you need to receive benefits
Lawsuits
Mass Mutual policies contain limits to the time to file a lawsuit against them. Furthermore, the time needed to get a case through the court process can be between a year and two years. The longer claimants wait to file a lawsuit, the longer those claimants will have to wait for results.
It is crucial that those who appeal or file a lawsuit get legal assistance from a disability expert. Our disability attorney, Nick Ortiz, and his legal team have years of practical experience with both ERISA and disability courts. Ortiz Law Firm can act as the intermediary between you and Mass Mutual and ensure that your appeal is handled correctly and fairly. We know that working with insurance companies such as Mass Mutual can be difficult, and we want you to focus on your health while we look after your appeal.
Why Should I Hire Ortiz Law Firm?
When your claim for Long Term Disability benefits has been improperly denied or wrongfully terminated, it is important to find an attorney with extensive experience handling LTD claims, appeals, and lawsuits. Florida disability attorney Nick A. Ortiz represents claimants nationwide and has helped numerous disabled persons obtain the long-term disability (“LTD”) insurance benefits they rightfully deserve.
We prepare and file your internal administrative appeal with the insurance company, collecting medical evidence and opinion evidence to maximize the chances that your LTD claim will be approved or reinstated. If your internal appeals are “exhausted”, we are prepared to file a lawsuit against the insurance company. We will make every effort to get your claim for monthly benefits approved or to obtain a favorable settlement.
The Ortiz Law Firm was founded by attorney Nick A. Ortiz, who has over a decade of litigation experience and has successfully handled dozens of Long Term Disability Appeals & Lawsuits. Mr. Ortiz prides himself on client satisfaction. He has a 5.0-star client rating with Martindale Hubbell and a 10.0 (superb) rating from the lawyer rating service AVVO. In 2014, Mr. Ortiz was nominated and accepted into The National Advocates: Top 100 Lawyers for Social Security disability law, which “is an invitation-only national organization composed of America’s Premier Lawyers. Membership is extended solely to a select few of the most qualified attorneys from each state who exemplify superior qualifications of leadership, reputation, influence, stature, and profile as lawyers practicing in designated aspects of the law.”
Nick Ortiz is an Experienced Mass Mutual Long Term Disability Attorney
As an experienced Long Term Disability lawyer, Mr. Ortiz approaches every case with intelligence and experience. He is familiar with strategies and tactics the insurance companies use to deny legitimate claims. Mr. Ortiz uses this knowledge to maximize the chances of securing the long-term disability benefits that you deserve.
Attorney’s Fees
The Ortiz Law Firm usually handles long-term disability claims on a contingency fee basis, which means that our fee is a percentage of the benefits recovered. Moreover, if there is no recovery, you do not have a fee. If your internal administrative appeal is successful and your monthly benefits are reinstated, we charge a percentage of the back pay that is owed and a percentage of your future monthly benefits for 12 months. We also advance any expenses.
Request a Free Consultation
Ortiz Law Firms’ lawyers provide advice to help ensure all disabled patients recover any benefits that were unfairly denied. We offer a free consultation to discuss your claim and the ways in which we can possibly assist you. If Mass Mutual withheld or terminated your disability insurance benefits, our disability insurance attorney can help determine the best way to get the benefits you are entitled to.
Call (888) 321-8131 for a free consultation. Mr. Ortiz would be honored to discuss your unique situation and explore your possible options.
Request a Free Policy Evaluation
If you are considering purchasing a disability insurance policy or have recently purchased a policy, we will help you understand what you are entitled to and whether there are deficiencies in your coverage that could lead to a denied claim. It is easy for individual policyholders who are not trained to read insurance policies to misread or misunderstand the disability policy. As part of our evaluation, we will explain what everything means to you in your situation.
Some of the aspects of your policy we will review include:
- Total versus residual disability;
- Own occupation versus any gainful occupation;
- Mental and nervous disability benefit limitations; and
- Self-reported conditions benefit limitations.
Fill out the form below to submit your request, and please allow 10 business days to receive your free Policy Evaluation Report.