Tuesday, April 08, 2025

MetLife gets reamed by New York judge

20:58 Publicado por Mario Galarza

Here is a case with MetLife's group disability plan for Eastman Kodak. The plaintiff suffered from chronic fatigue syndrome (CFS) and received all benefits.

MetLife decided the case review, and well, it has a very good job. Doctors rate them the plaintiff had not really any evidence use and if they did, they have so selectively.

There is no a test that can be used for CFS because it several symptoms is rather a mixture of as a disease. All tests, which said the applicant's primary care doctor to CFS pointed, said MetLife's docs they do not claim that there was no objective evidence of the condition. And when they have been asked again and again what the plaintiff could do, (remember, there is no test for CFS) provide objective evidence ignored the question.

Brilliant. Insurance companies want the proof to a level that is not possible. A final result of a non-existence CFS test.

The opinion above, linked is pretty good to read. The judge really goes to MetLife on some of its inconsistencies and gets to a MetLife doc report say, it "can be termed as sloppy and incomplete."

The whole point is that insurance companies, responsive and specific if they deny a claim. They must answer to the question of why the claim was denied and also explain, what would they need to accept it. If they don't, something is up.

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