As lawyers who represent claimants in long term disability benefit claims against the big insurance companies, including Metropolitan Life Insurance Company and Hartford Life Insurance Company, it was refreshing to see two recent court decisions ordering these companies to produce information which tends to show their conflict of interest in deciding disability benefit claims.
The first case to highlight is Sirey v. Metropolitan Life Insurance Company, No. CV 18-00197, 2018 WL 3928221 (E.D. La. Aug. 16, 2018). In this case, Magistrate Judge Karen Roby, granted in part MetLife’s motion to strike Sirey’s discovery requests, including interrogatories and requests for production of documents pertaining to MetLife’s conflict of interest. Judge Roby permitted the discovery requests relating to MetLife’s investigation of Sirey’s long term disability claim and its use of its medical reviewers, Dr. Marcus Goldman and Dr. Mark Schroeder and MetLife’s medical director, Dr. Puja Korabathina. Notably, Judge Roby permitted Sirey to seek copies of MetLife’s claim decision letters approving mental illness claims within the last three years. Judge Roby also permitted Sirey to seek copies of reports from Dr. Marcus Goldman and Dr. Mark Schroeder for the past three years. This is significant because not all courts considering long term disability benefit denials will permit this broad discovery, though it is clearly relevant to the decision-making process.
The second decision to highlight is Black v. Hartford Life Insurance Company, No. 3:17-CV-01785-HZ, 2018 WL 3872113 (D. Or. Aug. 14, 2018). In this case, Judge Marco A. Hernandez permitted Plaintiff to seek discovery about Hartford’s conflict of interest because it has a structural conflict and also has a history of biased claims administration. The court ordered Hartford to provide documents about its financial relationship with its vendors/consultants that is utilized in this case. It also found appropriate for Hartford to produce performance evaluations and related documents of key employees who participated in Black’s long term disability termination and the organizational chart that includes their assignments. The court denied Black’s discovery requests concerning the completeness of the record since there is no evidence that any records are missing.
In another long term disability decision from the same day, a different court denied discovery involving a deposition of a doctor but did find that another remedy for the insurance company’s failure to abide by the rules was appropriate. In Carty v. Metropolitan Life Insurance Company, et al., No. 3:15-CV-01186, 2018 WL 3861827 (M.D. Tenn. Aug. 14, 2018), Judge Aleta A. Trauger, previously remanded the long term disability claim to MetLife in order to conduct further proceedings because of the flaws in MetLife’s claims process. Frustrated with MetLife’s failure to comply with the Court’s Scheduling Order on remand, Carty sought to depose MetLife’s independent medical examiner, Dr. Ihrig. MetLife moved to quash the subpoena of Dr. Ihrig and/or to obtain a protective order. In response, Carty moved for sanctions against MetLife for breaching the court’s scheduling order and due process violations. In deciding the motions, Judge Trauger rejected MetLife’s argument that it has any kind of enforceable right or privilege with regard to its correspondence with an independent medical examiner it hired to review Plaintiff’s appeal. But, deposing Dr. Ihrig is not the proper remedy for MetLife’s violation of the court’s previous order. Instead, the court stayed further proceedings so that Carty has the opportunity to add to the record in response to Dr. Ihrig’s addendum report.
If you have a long term disability benefits claim that was denied due to the insurance company’s flawed and biased claims handling, it’s important that you consult with an experienced ERISA or insurance attorney right away. The team at Kantor & Kantor, LLP has over 60 years of combined experience fighting big companies on behalf of claimants seeking disability insurance benefits.