Metropolitan Life Insurance Company — “Metlife” — is becoming more of a player in the disability insurance arena.  The problem is that by using the word “player” we don’t mean just selling more disability insurance policies, we mean more active in denying, terminating, and litigating disability claims.

Disability insurers will often approve a claim after a brief initial investigation, but then later cut off the monthly benefits (a claim “termination”).  There are several possible reasons for an “approve and then terminate” scenario, and often the insurer’s reasons appear to be business / profit-motive related.

When a termination happens, the insurer gets to grab a pool of money that had been set aside for a particular claim.  That pool of money is known as a claim reserve.  If the company, such as Metlife, grabs the reserve money and then books it as profit, it can justify spending some money on legal fees toward a fight in court and hope that it can settle the case later date.  Once a lawsuit is filed, however, Metlife needs (by state law) to set aside a new reserve.  In such a scenario, Metlife is simply kicking the can down the road but also hoping that the disabled person will not sue, or, if he /she does, will not hire the right law firm and put up a good fight.

Quadrino Schwartz is one the nation’s leading law firms handling disability insurance clams and lawsuits.  If you or someone you know finds themselves on the wrong end of a Metlife claim denial or termination, contact us for a free claim evaluation by calling 1-800-745-1755 or by filing out a quick and simple form at http://www.disabilityinsurancelawyers.com/contact/ .

Many States allow a person to sue an insurance company for a “bad faith” denial or termination of an insurance claim.  If bad faith lawsuits are recognized by the law of your State and your insurance company deliberately decided to deny or terminate your long term disability claim without valid reasons, you may be able to recover money for things like emotional distress, financial harm caused by the insurance company’s conduct, and even punitive damages (to punish the insurance company).

Typically, to establish such a claim, a plaintiff must show that the insurance company had no reasonable basis to deny the insurance claim and the company knew or recklessly disregarded the fact that no reasonable basis existed for denying the claim.  An insurance company, however, may challenge claims that are fairly debatable and will be found liable only when the claim was intentionally denied without a reasonable basis. Because insurers may challenge claims that are fairly debatable, if a realistic question of liability exists, an insurer may withhold payment while determining whether there is a reasonable basis for the claim. Insurers will not be liable for good-faith errors in denying or delaying a claim. Accordingly, recovery is possible only if an insurer both errs in denying coverage and does so unreasonably.

In the context of disability bad faith cases, there are many ways in which bad faith can occur.  Claim denials or termination for financial reasons is an obvious act of bad faith.  While difficult to prove, there are ways to build a circumstantial evidence case against many disability insurers.  Another example of bad faith is a deliberately ignoring valid medical findings and then hiring a biased medical examiner to conclude that there is no disability.

Quadrino Schwartz has a track record of success in pursuing bad faith denials or terminations of long term disability insurance claims.  The lawyers at the firm have over 100 years of combined experience and will form a team to vigorously pursue such claims.

To have your claim evaluated, go to www.disabilityinsurancelawyers.com/contact for a free consultation.

Is it smart to buy disability insurance? And if so, when is the best time to buy it?

Naturally, without understanding your complete financial situation it is not possible to give a straight “yes” or “no” answer, but this post contains some basic considerations and recommendations.

You are far likelier to become disabled for half a year or even more during your working years than you are to die. Even at age thirty you have a one in five likelihood of becoming disabled for a year or longer.

Even one year without revenue could be catastrophic to your financial affairs. At the very best you would need to exhaust your emergency savings. At worst, you will not have enough saved up to cover all of your expenses and have to turn to taking on debt. In some situations, a long term disability can force a person into insolvency.

The best time to get disability coverage is before you are hurt or ill. You want to buy your insurance before anything happens to you, because if you wait, you might not be insurable. Also, the costs are more affordable when you are healthy.

If you have a long term disability and you have filed a disability claim that has been denied, you need to hire highly qualified long term disability lawyers. they can win your case or get you the settlement you deserve. A skilled disability insurance attorney can also help you get through the process of getting your claim approved and avoid a denial in the first instance.

Many claimants have heard or read about the scenario: your disability insurer calls you on the phone, sends out a field agent, or sends a letter proposing a lump sum payment to “buy out” either the future of your disability claim, a disputed portion of unpaid past benefits, or both. In many instances a buy out can be a desirable outcome, but the claimant needs to understand the ramifications, have confidence that the proposed deal makes sense, and that it is the best deal available. Using experienced legal counsel can be an invaluable tool in assessing whether crafting a buyout deal is the right thing to do and in cutting the best deal possible.

One of the first considerations for a claimant already receiving benefits is to determine the likelihood of the claim being terminated if the buyout proposal is rejected. Some insurers use the fear of a claim termination as a tactic to convince the claimant to accept a lower than fair amount. If the claim may truly be on the verge of a termination, however, there needs to be an assessment of the potential costs of a lawsuit and the likelihood of winning or losing the lawsuit. Those factors are essential in arriving at a sensible buyout figure. There are tried and true methodologies we use at this stage, in order to provide our clients with the best chance of avoiding a lawsuit and securing their financial future. For more information, visit our website at: http://www.disabilityinsurancelawyers.com/practice_areas/more/negotiating-disability-settlements.

Another important piece of the puzzle is to have a realistic assessment of morbidity and mortality in order to make appropriate adjustments to the total future expected disability payments. Many claimants have missed the opportunity to receive a favorable lump sum by failing to have such an assessment. In addition, the claimant needs a thorough understanding of the “present value” concept in order to calculate the true value of the investment power of a current lump sum of future benefits.

It is also critical to know thine enemy: is the insurer testing the claimant’s mettle or really looking to buy out the claim? Different insurers use different techniques and thus having knowledge of the prior tactics of the insurer is invaluable.

When it comes to a buyout during litigation, the cost and risk factors for further litigation and the potential outcomes are much more prominent factors than in the claim context. Knowing how the litigation will play out under ERISA, for example, is critical, especially since there are land mines at every turn that can cause a claimant’s case to be dismissed entirely.

In summary, buyout strategies are complex and critical, and disability attorneys with years of experience can navigate the claimant to a successful outcome.

After Quadrino Schwartz obtained class certification in the first-of-its-kind national class action against disability insurer UnumProvident (Unum), the firm looks back at the long and hard fought battle that has preceded this critical court ruling.

When the case was filed in 2002, the attorneys at Quadrino Schwartz could hardly have predicted the course of events in their class action against UnumProvident, the disability industry giant. They knew this: the case was a serious and ground-breaking lawsuit that had a great chance to help thousands of disabled Americans. What they didn’t know was how many twists and turns there would be until that critical moment in the case: class certification.

In late 2002 and early 2003, the case was on a fast track in a federal court in Manhattan. A custom crafted evidence preservation order was obtained to preserve critical emails, yet as the order was being signed, emails were being destroyed. Those events culminated in a unique and important trial on evidence destruction in which Partner Richard Quadrino and a team of lawyers at Quadrino Schwartz took on one of the nation’s powerhouse law firms. The trial ended with critical findings of wrongdoing by UnumProvident and a massive effort to have thousands of emails restored for future use in the case.

The legal theories and approaches in the case were approved by the court when UnumProvident tried to get the case dismissed. The Court approved the method designed by Quadrino Schwartz to allow a class action aimed at reforming the practices of a Fortune 200 Company to comply with the law and stop its illegal use of financial budgets and targets in the claims process.

Another unprecedented move by Quadrino Schwartz was the seizure of files from the desks, credenzas and drawers of all of the company’s top officers to prevent further evidence destruction. A massive effort was ordered, as requested by Quadrino Schwartz, to box up and ship out 1,500 boxes of critical information to be preserved and used in the class action.

After the case was transferred to Tennessee and joined with a series of other similar cases filed in other parts of the country at a later date, the court in Tennessee tried on numerous occasions to get UnumProvident to engage in serious settlement discussions. The company refused, and the case dragged on for years.

Quadrino Schwartz never gave up the fight, however. The pressure applied by the case and the publicity from CBS 60 minutes and other media prompted a government investigation. That investigation culminated in a 48-State settlement in which UnumProvident agreed to some reforms of the company and it mailed notices to thousands of people to have their denied claims re-assessed.

The deal had significant shortcomings, however, and Quadrino Schwartz continued to push for the appropriate relief for all victims of the company’s bad faith practices. Even after many Plaintiffs settled and walked away, Quadrino Schwartz and its clients have stayed in the fight, believing that a better day was ahead and that persistence in seeking justice would see its rewards.

Now that a class is certified, Quadrino Schwartz will move into the next and critical chapter of this drama, undeterred and with a determination to see to it that complete justice is achieved for all disabled victims of UnumProvident’s profit-driven scheme. Unum has appealed the class certification decision and argument in the appeals court took place in September. A decision should be forthcoming soon.

For more information and links, visit our minisite at: http://unumprovidentclassaction.net