January 7th, 2011

Ms. Holmstrom suffered from a painful nerve condition in her right arm which did not resolve even after three surgeries.  She was left with an incurable diagnosis of complex regional pain syndrome (CRPS).  MetLife paid benefits until the definition of disability changed from an inability to perform the material duties of one’s own occupation to that of any occupation.  MetLife cited the lack of any objective evidence to support Ms. Holmstrom’s diagnosis of CRPS.
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June 19th, 2007

In newer life insurance, disability insurance, and health insurance polices (less than 2 years old) insurers attempt to avoid paying claims by performing what is known as “post claim underwriting.” When you purchase a health, disability or life policy, you fill out an application that asks questions about you and your family’s health, give the insurer a medical authorization, and sometimes undergo a medical exam. Instead of using the authorization to get the applicant’s medical history before wrting the policy, the insurance company waits until a claim is made. At that time, they obtain your medical records to determine if your statements on the application for insurance was 100% absolutely accurate. If not, then the insurance company rescinds (retroactively cancels) the policy, refunds your premiums, and denies your claim.
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April 9th, 2007

An accidental death insurance policy will pay benefits when the insured dies as a result of an accident. But when the insured dies in an auto accident with a high blood alcohol rate is that an accident? Metropolitan Life Insurance Company recently denied a widow life insurance benefits when her husband died in a single car accident while driving home from his brother’s house. Met Life claimed that since decedent had been drinking beer before driving that the accident was not an accident under the law.
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