Supreme Court Weighs Insurer's Conflict of Interest in Claim Denial
National News • April 28, 2008
The Supreme Court struggled last week with how much weight to give an insurance company's potential conflict of interest when it denies an employee's health or disability benefits claim.
The ...
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Subject: RE: disabled?
Posted On: April 28, 2008, 2:45 pm CDT
Posted By: bob
Comment:
Apparently MetLife did not even give the full medical reports to the experts they relied on in their denial -- only a brief portion that supported the denial. The Sixth Circuit said. "MetLife's decision to deny long-term benefits in this case was not the product of a principled and deliberative reasoning process. MetLife acted under a conflict of interest and also in unacknowledged conflict with the determination of disability by the Social Security Administration. In denying benefits, it offered no explanation for crediting a brief form filled out by Dr. Patel while overlooking his detailed reports. This inappropriately selective consideration of Glenn's medical record was compounded by the fact that the occupational skills analyst and the independent medical consultant were apparently not provided with full information from Dr. Patel on which to base their conclusions."
Subject: RE: disabled?