MetLife

As a long-term disability attorney, I have seen firsthand the difficulties individuals face when insurance companies unfairly deny their long-term disability benefits. I would like to share with you a case in which we successfully recovered MetLife long-term disability benefits for a claimant in Texas. This case not only highlights the complexities of disability claims …

Ortiz Law Firm Recovers MetLife Long-Term Disability Benefits For IBM ConsultantRead More

The case of Howard Schmill v. Metropolitan Life Insurance Company (MetLife) involved a long-term disability (LTD) claim under a plan governed by the Employment Retirement Income Security Act of 1974 (ERISA). Please note that the Ortiz Law Firm did not handle this case. Schmill, a Louisiana resident, was a foreman at Turner Industries Group, LLC, …

Schmill v. MetLife – Court Upholds Decision To Limit Benefits To 12 Months In Claim For Mental And Musculoskeletal DisordersRead More

The plaintiff, Sutton, filed a lawsuit against MetLife, the defendant, for the wrongful denial of long-term disability benefits under his employer’s plan governed by ERISA (Employee Retirement Income Security Act). Background Under the disability plan’s policy documents, if an employee’s disability is attributable to a neuromuscular or musculoskeletal condition, benefits are normally paid for only …

Sutton v. MetLife – LTD Policy Requires Objective Evidence, Not Conclusive ProofRead More

Ms. Fowkes does not contend the Plan’s written evidence requirement violates ERISA. Instead, she takes issue with MetLife’s procedures to evaluate her LTD claim. In particular, she contends MetLife required her to present “objective evidence” supporting her LTD claim. At the hearing, she argued that MetLife did not consider the cumulative effect of her conditions in determining whether she adequately established disability. MetLife contends subjective reports of pain need not be taken at face value and argued at hearing that no disability is established even when considering Ms. Fowkes’s conditions in combination.

Fowkes v. MetLife – Plaintiff Did Not Prove to Unum That She Was DisabledRead More

MetLife forwarded responses from Santana’s treating physicians to Dr. Simon, an “independent physician,” who reviewed them and concluded that the MRI was normal for a person of Santana’s age and that Santana had still failed to submit clinical evidence showing that he had either radiculopathy or any limitations due to neuropathy. By a letter dated August 19, 2011, MetLife denied Santana’s administrative appeal and upheld its earlier decision to deny him continuing long-term disability benefits. The Court agreed with MetLife that.

Santana-Diaz v. MetLife – Court Rules Clinical Is Not An Ambiguous TermRead More

In granting summary judgment for MetLife, the district court reasoned that when Sumpter became disabled, Delphi’s plan did not provide the benefit he sought and that he was not entitled to equitable relief. The U.S. Court of Appeals for the Seventh Circuit upheld this decision.

Sumpter v. MetLife – Court Rules Lawsuit Against MetLife Is FrivolousRead More

A Court must take into consideration the conflict of interest inherent in a benefits system in which the entity that pays the long-term disability benefits maintains discretionary control over the ultimate benefits decision. This is done by weighing the structural conflict as one of the many factors relevant to the benefits determination decision. However, this conflict of interest …

Glenn v. MetLife – Understanding How Courts Evaluate Long-Term Disability LawsuitsRead More

The Court held that MetLife undermined the ERISA process by failing to issue a proper denial and, further, by failing to notify the insured about the issues in dispute. The Court ordered MetLife to pay past-due benefits, with interest, and to continue paying benefits so long as they continue to remain due under the provisions of the Plan, unless and until MetLife issues a denial that is in full compliance with the requirements contained in ERISA.

Tash v. MetLife – Court Holds That MetLife Undermined The ERISA ProcessRead More

In this case, Teresa A. Seeman (“Seeman”) was an employee of Bank of America and served as a Vice President, Unit Manager from May of 1990 to December of 2007. Through her employment, she was part of a long term disability plan that was administered by Metropolitan Life Insurance Company (“MetLife”). The plan defined “disability” as follows: By June …

Seeman v. MetLife – Vice President Wins Long-Term Disability ClaimRead More

Case Name: Randall v. Metropolitan Life Insurance Company Court: United States District Court for the Northern District of California Date of Decision: February 6, 2017 Type of Claims: Short-term disability, long-term disability, and related health, dental, vision, and life insurance benefits. Insurance Company: Metropolitan Life Insurance Company, aka MetLife. Claimant’s Employer: Verizon Wireless Claimant’s Occupation / Job Position: Facilities Network Engineer Disabilities: Randall …

Randall v. MetLife – Doctor’s Conclusion Outweighs Subjective ComplaintsRead More