Field Visit

Wednesday, June 25th, 2008

Disability Insurance companies always insist on receiving extraneous information when evaluating an application for disability benefits. Sometimes they insist on tax and financial records even if the benefit is a fixed amount, completely independent of income. The insurance companies frequently demand monthly statements and certifications from the applicant’s doctors even if the doctors have made it clear that the medical condition at issue is permanent and progressive. The insurance companies cite to sections of the disability insurance policy in support of their right to compel applicants to complying with the information demands, even when admitting that the right to information does not mean that they should ask for the information.

The terms and conditions of a disability insurance policy provide a two-way street. When a disability insurer makes requests for information beyond completing the application forms, check to see that the request is encompassed by the policy. MetLife has been demanding monthly attending physician statements and financial statement from one of my clients. MetLife was unable to explain why they needed the information, but cited the policy sections that provided it with the right to the information and insisted on compliance with those terms. Additionally, MetLife requested that I allow one of its field investigators to interview my client. When I asked MetLife to cite the section of the policy that entitled it to a field interview, MetLife responded that field interviews were part of its standard practice and procedure.

My client suffers from bipolar disorder and anxiety. The thought of a field interview unnerved him greatly. Since MetLife had cited sections of the policy to demand compliance with their irrelevant financial and medical information requests, I cited the absence of a section of the policy permitting a filed interview to deny that request. MetLife has approved the claimant’s benefits, but it is possible that it would have arrived at a different conclusion if its field investigator had been allowed an interview.

Previous Next