Disability Claims Solutions

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Out of whackFor the last 20 years I’ve always described MetLife as a “bottom feeder” insurance company. My opinion was at first derived from the company’s complete lack of customer service and fair appeal procedures, but recently my opinion is based on numerous reports of failure to pay even when other insurance companys pay claims for the same impairments for the same insureds.

MetLife is only one of several disability insurers who, in the last five years, have adopted an aggressive anti-insured philosophy to investigate claims to deny rather than to pay. Guardian/Berkshire and Mass Mutual are also insurers whose failure to pay claims “when disability is reasonably made clear” is increasingly reported from insureds themselves as companies of “No.”

In the past, MetLife provided one of the worst systems of Customer Service I have ever encountered in the disability business. On several occasions I had to contact the corporate public relations offices in order to be connected to someone who could give information about a claim. Even then, supervisors mouths were moving, but nothing of substantive help was communicated.

Even then, bumping up the hierarchy to supervisors, it appeared to  me that no one had a clue. Most state laws require insurers to maintain competent, non-negligent claims processes, including Customer Service, but MetLife has yet to implement even adequate Customer Service and this has been going on for years.

One of MetLife’s pitfalls is that it seems to take the company forever to review medical information and obtain documentation. While part of the problem involves claims handlers “dropping the ball”, problems seem to also involve under staffing and hiring third-party reviewers who are at least an arm’s length away from caring about claimant’s financial needs. Ourtsourcing, while potentially cost-effective, is NOT the most efficient and timely way to investigate and process claims.

Despite the chaotic mess of MetLife’s internal claims investigations, professional associations and other employers continue to spend their employee benefit dollars ill-advisably with MetLife. Given my current experience with MetLife the company does not make timely decisions, and when they do, most decisions result in denials earning MetLife a new public reputation as the company of “No.”

As I indicated previously, although MetLife never really did have a good reputation, in my opinion, the public’s impression of MetLife grows worse and worse with reports of untimely and unfair claims decisions.

Therefore, my current opinion is that employers should think twice about spending benefit dollars for group insurance that actually “costs” employees in the long run. MetLife and the other bottom feeder companies just isn’t worth the hassle anymore.