MetLife

Retain legal counsel before applying a band-aid to MetLife's wounds

Reviewed by Julie B. on March 14th 2015   Verified Policyholder
Having previously commented and questioned MetLife’s claim handling I am of the opinion anyone who has a short and/or long term policy with them governed by ERISA should retain legal counsel before they even apply a band-aid to the wound. Their latest tactic was to Fedex a check to me with notice my claim was closed after March 1, 2015, yet provided no reason or explanation, but I had until March 15 to appeal. So I called them, but they have not returned calls from me or my doctor since I received this notice and check, and I have no idea how to appeal since they provided no reason and did not provide their usual medical update form with the check. My own employer will not instruct me on what to do, and I know from reading the letter accompanying the last check my claim is considered closed as of March 15, 2015. Better yet they told my employer I would return to work March 1, and I received notice of that via email from my employer March 4 then by mail March 11. Hard to appeal when you cannot get a call back from the insurance carrier, and even more difficult if your own employer has told you to only communicate with their attorney on the matter and he, too, will not return calls or emails. My GI doctor spoke with my MetLife case manager February 27 after my appointment with him for a planned medical update “chat” and made it clear the soonest I could return to work while still being treated for ulcerative colitis would be mid April; how did they turn that in to my being at work 3 days later? I did contact his office immediately upon receiving notice my claim would be closed, and all they can do is leave messages at MetLife; something they continued to do after my March 10 appointment as well. And why do I not have anything in writing from anyone on how this decision was made? All I know is my functional capacity still does not meet the requirements of my job, and that was communicated to MetLife by my physician verbally and in written updates. How can I fight this battle when I don’t even have an idea what I am up against?
Reply
Sent on March 14th 2015 by Attorney Stephen Jessup

Please feel free to contact our office to discuss your claim in much greater detail. If your claim was closed effective March 15 you will have the ability to submit an administrative appeal to challenge the decision.