Another judge has found that Met Life abused its discretion in its consideration of a long term disability insurance claim. By relying upon physicians who derive substantial income from providing medical reports to insurance companies, Met Life failed to support its claim determination with “substantial evidence”, and its determination was reversed.
Met Life utilized a cadre of paper reviewing doctors, eschewing its right to actually examine the claimant, and relied upon stale surveillance video obtained of the claimant. The Court also found that Met Life failed to provide the claimant with a full and fair review as it is obligated under ERISA. The Court noted that Met Life’s financial conflict of interest was a significant factor in its determination. Solomon v. Met Life, (SDNY 2009).