Metropolitan Life (MetLife for short) is a well-recognized insurance company across the United States. MetLife is the largest life insurance company in North America, founded in 1863. MetLife offers a wide variety of insurance policies, including contracts for long term disability benefits. MetLife sells group disability insurance protection to employees as “fringe benefits” through employers, and the Metropolitan Life Insurance Company also sells individual disability policies directly to individuals (outside of a group plan).
You may be one of the few who actually have Long Term Disability (LTD) benefits. If so, you had the foresight to purchase very important insurance coverage to replace your wages in the event that you became unable to work due to an injury or disability. MetLife’s long term disability coverage provides such financial support. Unfortunately, having a long term disability insurance policy is not enough. You must still file an application for benefits with MetLife, and the insurance company evaluates your claim to determine if you qualify for benefits under your LTD Plan.
Yes. You read that right. MetLife is the one who reviews your claim to determine whether it must pay you benefits under the policy. Most of us consider that a conflict of interest. It is troubling to think that although you had to stop working due to a severe injury or illness, MetLife could still deny your claim.
In other words, although you may qualify for disability benefits, that does not necessarily mean that MetLife will approve your long term disability insurance claim. Many individuals who become disabled, meet all the requirements for long term disability insurance benefits, and therefore apply for LTD benefits are still denied by MetLife. Others are cut-off of their benefits after having received LTD benefits for several months or several years. In short, MetLife wrongfully denies long-term disability benefits to many disabled claimants each year. If your LTD claim has been wrongfully denied, delayed or terminated, you should seriously consider hiring a MetLife long term disability lawyer.
At the Ortiz Law Firm, we understand how critical long term disability benefits can be to you and your family to replace your lost income while you are unable to work. We also understand how difficult it can be to fight for your benefits when you are already dealing with serious physical and/or mental medical condition. Fortunately, you do not have to face the disability application and appeal process alone. Mr. Ortiz is a MetLife disability claims attorney with the knowledge and experience to help you navigate the claims process or appeal the denial of your claim.
Filing Your Initial Disability Claim
The following is a shortlist of some of the documentation you will need to file your initial claim:
- Medical records;
- Doctors’ opinions and notes, such as an Attending Physician’s Statement or Assessment of Residual Functional Capacity;
- Financial statements; and
- Pay stubs.
Once all of the required information and documentation has been gathered, you must timely submit it to Met Life within the required “Proof of Loss” time period.
Appealing a Denied Claim
If you have received a denial letter or cut-off letter, the first thing you must understand is that you have the right to appeal a denied claim. Mr. Ortiz can help you understand the reasoning behind your denial and what may have been lacking in your initial application for benefits.
An appeal should not be taken lightly. Once retained, Mr. Ortiz does not just file an appeal letter to MetLife saying simply, “We appeal.” Based on years of handling long term disability denials, Mr. Ortiz is familiar with the additional medical and opinion evidence you should file with your appeal to the MetLife claims department. Such information may include evidence from doctors, friends and family, and clients themselves. Your appeal to MetLife may consist of all or some of the following:
- Updated medical records;
- Opinion letters in support of your claim from your doctors;
- Your declaration;
- Declarations from friends, family, and/or co-workers;
- Independent medical evaluations; and
- Functional Capacity Evaluations.
Mr. Ortiz helps his clients gather and organize all of the required information and documentation, and helps his clients complete the appeal in a manner that gives his clients the best chance of successfully obtaining benefits. We understand how vital these disability benefits are to our clients.
Should the appeal with MetLife also be denied, you may have the option to either file a second appeal (if your policy allows it) or file a lawsuit under ERISA. In an ERISA case, a federal judge will review your claim and make a determination as to whether Met Life’s decision was proper under the policy and under the law.
Metropolitan Life Insurance, or Met Life, Long Term Disability Insurance Claims Attorney
Mr. Ortiz is the founder of the Ortiz Law Firm. Mr. Ortiz has successfully represented many MetLife disability insurance policyholders in their fight to obtain or retain their disability benefits. We work with clients on MetLife long term disability insurance claims.
Mr. Ortiz is an experienced LTD disability benefits attorney and will work with you through each step in the appeals process. Mr. Ortiz has handled numerous MetLife LTD appeals and will use this experience to work with you to build the evidence that will be critical to improving the chances of winning your case.
Although most disability policies give you 180 days to file an appeal, we need as much time as possible to develop the best case for your appeal. That’s why it is so important to contact us as soon as you receive your denial letter from MetLife.
If you are a MetLife long term disability policyholder and your disability claim has been denied, delayed or terminated, contact our office online or call 850-308-7833 to schedule a free case evaluation.