This case involves a long-term disability lawsuit against Lincoln National Life Insurance (administered by MetLife).
Our client is a chiropractor that is totally disabled following a five level cervical fusion surgery. Met Life paid benefits for approximately 18 months following his surgery and then denied his benefits. MetLife opined that based upon a review of the medical records by their in-house orthopedic, our client could return to work as a chiropractor.
Our client is considered totally disabled if he is unable to perform the substantial and material duties of his occupation. The case is pending in Orlando, Fl (state court) as the policy was delivered in Orlando.
Attorney Gregory Dell of Dell & Schaefer, filed a Motion to Compel, in an effort to obtain documents from the 10 page privilege log that Met-Life filed when they turned over the 1,580 claim file documents. MetLife’s privilege log included all in-house medical reviews by their consulting orthopedic and chiropractor. MetLife file a response to our motion to compel the day before the hearing. The judge deferred ruling at the hearing and then the day before the depositions of the Met-Life employees, MetLife released all of the privileged documents that Plaintiff was seeking.
MetLife’s actions are just another example of their delay tactics. Furthermore, there is an inherent conflict for Met Life to claim that medical reviews of a claimant’s file prior to the rendering of a claim decision is work-product. A work-product document is a document prepared in anticipation of litigation. A disability insurance company has a duty to evaluate a claimants claim for disability and these documents are not prepared in anticipation of litigation unless it is assumed that the disability company is going to deny the claim.