Question

Is it legal for MetLife to change the definition of disability?

Asked on May 26th 2016 by Robert
I was put on std from my employer then it turned into ltd 2 level spine fusion with a morphine pump in my stomach feeding my spine due to pain. I got ssd of 1800 and that amount subtracted from ltd payment which leaves me 450 a month from metlife. They have asked for 5 different time a functional cap test. Dr pretty much said no work no lifting no bending and so on. Jan. Metlife called and told me deffinition of disability changes. How can they change definitions of words, is that legal? Can I change definitions also? If they can I should be able to. If my doctor said I can’t work can Metlife say oh I can work? They said they take into consideration my age what I can do and it must be 80% of my gross pay when I was working. I have been a welder only which no way I can do now. Whats going to happen in nov 2016 80% comes out to 16.50$ an hour. Will they try to cancel me and my crummy 450 a month?

Answer

Answered on May 20th 2016 by Attorney Stephen Jessup

Robert, with respect to your question as to change in definition of disability- yes, that is legal. Your policy has language that reads after a certain period of time (usually 24 months) disability will be defined to mean the inability to perform any occupation and in your case it looks like it would have to pay you 80% of your pre-disability earnings. MetLife can always have your claim reviewed by a doctor and if that doctor disagrees with your doctor’s opinion that could be enough for MetLife to deny your claim prompting need for an appeal. Have you performed a functional capacity evaluation? Please feel free to contact our office to discuss your claim. There may even be a chance to try to secure a lump sum buyout of the policy from MetLife.

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MetLife

They FULL OF ****

Reviewed by KM on October 3rd 2024   Verified Policyholder | August 2024 date of disability
MetLife is what everyone on this review are saying. They don't contact you to let you know what's going on with your claim or to let know you need additional info. I had a... read more >
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MetLife for disability? Avoid the surgery unless it's life-threatening

Reviewed by Jeff on August 22nd 2024   Verified Policyholder | August 2024 date of disability
The worst company I ever dealt with, never received a call from my claim manager.
MetLife

Only care about $$$$$

Reviewed by Allen Cox on August 8th 2023   Verified Policyholder | September 2013 date of disability
PLAY THEIR GAME FIGHT FIRE WITH FIRE.....after getting a copy of the insurance policy from my HR. I nipped a lot of the headaches quickly by calling their bluff word for w... read more >
Reply
Sent on August 8th 2023 by Attorney Gregory Dell

Allen,
Sorry to hear what you have been through. I am glad you fought back.

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They demanded an overpayment, stopped my claim, and lied about it

Reviewed by Diana R. on May 28th 2022   Verified Policyholder
Metlife over paid me. Stopped my Ltd claim. The overpayment were not done right. They lied and said they deposited money in my account.
Reply
Sent on May 28th 2022 by Attorney Alex Palamara

Diana, I am sorry to hear of this denial and the demand for an overpayment. Please contact us so that we can review your claim and see if we can get you back to receivi... read more >

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Your decision making process is absurd!

Reviewed by Brian on June 1st 2021   Verified Policyholder
My wife went through a nightmare with a back surgery for two discs. When the first surgery took place, the Dr. cracked a different vertebrae as they placed the metal rods ... read more >
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My husband has 2-5 yrs to live, yet MetLife has been giving him the run around

Reviewed by Tina on March 19th 2021   Verified Policyholder
My husband has STD and LTD with his employer. He was dx with ALS/Lou Gehrig’s Disease Aug 2019, made official after many many test, as of Jan 2020 but continued to work ... read more >
Reply
Sent on March 19th 2021 by Attorney Gregory Dell

Tina, I am so sorry to hear that MetLife and the employer have been giving you the run around. From everything that you described, your husband’s claim should be a qu... read more >

MetLife

Inappropriate conduct!! Rude, discriminatory, etc

Reviewed by Deanne on January 31st 2021   Verified Policyholder
Have you ever dealt with a case where the person is receiving LTD benefits but there have been issues with the case manager? For instance, the person was badgered about an... read more >
Reply
Sent on January 31st 2021 by Attorney Jay Symonds

Deanne: This certainly does not sound like appropriate conduct on the part of the claims personnel. Are you still collecting an LTD benefit? I suggest you contact our o... read more >

MetLife

Haven't been paid since MetLife denied my appeal months ago

Reviewed by Rosanne on December 8th 2020   Verified Policyholder
I was denied my appeal with Metlife, and I am still seeking medical diagnosis for other health issues. I was diagnosed with Chronic Gastritis and am now being tested for R... read more >
Reply
Sent on December 8th 2020 by Attorney Gregory Dell

Rosanne, I am sorry to hear of your denial. Please contact at once for a free consultation. We should be able to assist you with the next available steps.

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