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Mass Mutual Disability Claims Lawyer

CaveyLaw.com > Disability Insurance Companies > Mass Mutual Disability Claims Lawyer

You bought your Mass Mutual disability insurance policy with the promise that Mass Mutual would be there for you and your family if you become disabled and unable to work.  You thought you were buying financial peace of mind!  Not with Mass Mutual who I personally think are one the worst disability carriers in the United States. If you were denied a disability claim with Mass Mutual, hire an experienced disability attorney like Nancy Cavey to get the help you need.

A History of Mass Mutual

 

Massachusetts Mutual Life (Mass Mutual) is owned by Mass Mutual Financial Group. It was founded in 1851 and during the gold rush sold high premium insurance policies to railway and steamship workers and gold rush miners. As the country grew, so did Mass Mutual. It even had offices in San Francisco before the Transcontinental Railroad was completed in 1869.

 

Mass Mutual has, over the years, developed a diversified financial services company and offered a wide range of financial products, including pensions and other retirement products. They also invented the waiver of premiums in the case of disability.

 

Tremont Capital Management and Bernie Madoff

 

Tremont Capital Management was a feeder fund that invested in Bernie Madoff’s Ponzi schemes and ultimately lost 3. 3 billion dollars. It has paid a settlement of over 1 billion dollars to the receiver who is recovering money from the Ponzi scheme. It is one of the largest private disability insurance companies in the United States and offers what is called an individual disability or ID policy to doctors, dentists, and other professionals to protect not only their income but their lifestyle.

 

Common Disputes with Mass Mutual

 

Some of the many disputes that arise are the date of disability, claims for residual disability when the professional continues to work, the occupation the policyholder is performing when they became disabled, total disability and the coordination of the Mass Mutual policy with other ID policies or ERISA group disability policies the policyholder may own. That coordination is a key issue since many of my Mass Mutual clients have more than one disability policies with different carriers. It is like untangling Christmas tree lights before you plug them in.

 

I have written the go-to book for professionals called, “The Disability Insurance Claim Survival Guide for Professionals“.

 

You owe it to yourself and your family to get a copy of the book before you stop working and apply for benefits.   After all, you have spent hundreds of thousands of dollars in schooling and training and you need to know if you have adequately protected your career. While you may work regularly with insurance companies, you are not an expert on disability insurance. In fact, fewer than 200 lawyers in the United States are what I would call an expert and I am one of them.

 

What You Can Expect from Mass Mutual:

 

  • Use in-house nurses to review medical records and reach medical conclusions about the policy-holders restrictions and limitations even though those nurses may have no training in or qualifications to render any opinions about the policyholder’s medical conditions,
  • Use biased medical peer review providers to create medical justifications for a claim’s denial so Mass Mutual can claim that you are capable of performing the material and substantial duties of your occupation,
  • Use in house accountants to determine your pre-disability earnings and calculate your residual benefits, based on their analysis of your books, billings, and schedule,
  • Use surveillance companies to discredit the policyholder’s complaints,
  • Use any excuse to schedule a personal visit to your home to show you “Dancing with the Stars” video they have and give you the “we got you now” award that will result in the termination of a claim.
  • Use in-house vocational evaluators to misclassify your occupation and your ability to perform your occupation, perform questionable transferrable skills analysis and misinterpret the wages of and availability of other occupations it will claim the policyholder can do to justify the denial or termination of benefits.

 

Mass Mutual is also known to make endless and multiple requests for medical, financial, and vocational information before it figures out a way to deny benefits. This delay and denial strategy drains the policy holder’s bank accounts as they try to stay financially afloat. Your claim is a very expensive claim and will cost them big bucks. Mass Mutual has nothing to lose! You need an experienced lawyer, like myself, who battles Mass Mutual daily.

 

What You Can Expect from Mass Mutual Disability Claims Attorney, Nancy Cavey:

 

  • A thorough review of your policies,
  • A thorough review of your medical records,
  • The creation of a pre-claim strategy to obtain your benefits on the first application,
  • An appeal in response to a wrongful denial or termination by drafting an appeal letter 25 to 60 pages long that is the trial of your case and goes to Mass Mutual inbox,
  • A dedication to protecting you from Mass Mutual’s aggressive claims handling process, including the delay game, we need more information game, we want to take your statement game or we want to have you under an independent medical examination or FCE,
  • Aggressively litigating your case, if need be.

 

Don’t let Mass Mutual make you a victim like Bernie Madoff’s former clients.

 

Mass Mutual plays games with initial applications and makes endless and multiple requests for medical, financial, and vocational information before it figures out a way to deny benefits. This delay and denial strategy drains the policy holder’s bank accounts as they try to stay financially afloat. It is their business model.

 

Mass Mutual uses “liar for hire” doctors who give them the ammunition it needs to justify a claim’s denial or termination. Mass Mutual rarely tells a denied policyholder the real reasons the claim was denied. Worse yet, Mass Mutual hopes you just give up getting the disability benefits you deserve!

 

Don’t think that Mass Mutual doesn’t play the claims delay, denial, or termination game with individual disability policies. They are and the policy benefits at stake are often much high so there is much more to lose if you aren’t represented by a Mass Mutual individual disability attorney like me. Worse yet, Mass Mutual fails to fully explain what you need to submit to successfully win an appeal.

 

That’s why it is crucial that you be represented at both the initial application and appeal stages of a Mass Mutual claim by an experienced disability lawyer who battles Mass Mutual on a daily basis.

Don’t Face Mass Mutual Alone

 

Once the appeals process is exhausted (and that really means you are exhausted by the endless requests for information and battling with Mass Mutual), the only recourse is to file a lawsuit. If you purchased your insurance through your employer, the policy is most likely governed by ERISA (Employee Retirement Income Security Act).

 

Given its name, the ERISA statute and regulations are ironically NOT policyholder friendly.  You CANNOT add anything to the claims file after the last denial so all the Federal judge gets to see is what is in Mass Mutual’s file which is stuffed with medical and vocational opinions that are favorable to Mass Mutual. If you didn’t know enough to get the claims file when you appealed, didn’t know enough to add medical, vocational, or lay evidence to the file, or didn’t make the right arguments, you have all but destroyed your case.

 

An appeal of a denied Mass Mutual claim is the trial of your case. Taking on a tough insurance company like Mass Mutual is an endeavor for a specialist. A federal judge will give Mass Mutual the benefit of the doubt because Mass Mutual policy requires you to prove they are wrong and not the other way around. You owe it to yourself and your family to have an experienced disability attorney, like me, take on Mass Mutual. After all, this is about getting the disability benefits you deserve and you paid for.

 

Some policyholders have bought their own disability policy through an agent and that is known as an individual disability insurance policy. The game is the same but the playing field is more level because any claims denial can be challenged in state court which is a friendlier place to be if you have to sue Mass Mutual. Don’t think that Mass Mutual isn’t playing the claims delay, denial, or termination game with individual disability policies. They are, and the policy benefits at stake are high. There is much more to lose if you aren’t represented by a Mass Mutual individual disability attorney like me.

Mass Mutual Offers Three Types of Disability Policies:

 

The kind of policy that you have will tell you what your rights are and determine if you are being treated fairly.

 

1) Group ERISA Disability Insurance

 

Mass Mutual offers disability policies through employers governed by ERISA. A Mass Mutual ERISA policy generally has the following:

 

  • very strict definitions of occupation and disability,
  • limitations on how long payment will be made for mental conditions or subjective conditions like  headaches, pain, fibromyalgia or chronic fatigue,
  • “other income” provisions that allow for a dollar for dollar reduction for the receipt of Social Security disability benefits, workers’ compensation benefits, and personal injury settlements, and
  • A “golden handcuff” on a judge that only allows for a claims denial or termination reversal if Mass Mutual’s decision is “arbitrary and capricious.”

 

2) Group Non-ERISA Disability Insurance

 

However, a group plan offered by a church plan, such as the Catholic Church, or by a municipal employer like the City of Baltimore, Baltimore County, or the State of Maryland is NOT generally covered by ERISA. The policy terms are much like those of an ERISA plan but there is one CRUCIAL difference. A claim’s denial or termination can be challenged in state court and new evidence can be submitted at trial.

 

State law courts are a much friendlier place for a policyholder than Federal court. You are entitled to a jury trial in a state law claim and not some Federal judge just making a decision based on Mass Mutual’s file stuffed full of things that are unfavorable for you!

 

3) Individual Disability (ID) Insurance

 

Without a doubt, the best and most expensive policy is a private individual disability policy known as an ID policy. The policy terms and coverage are broader and more generous. But that means a high monthly premium and a lot of financial exposure that Mass Mutual has if you become disabled.

 

It isn’t uncommon for Mass Mutual to invoke a pre-existing exclusion or a medical condition policy rider right out of the box as a way to justify a denial of the claim from the beginning of the claim. That is just one reason why it is so important for a policyholder to contact me BEFORE they stop working and apply for benefits.

 

You can bet that Mass Mutual will be looking for a way to say that you are disabled as a result of carpal tunnel syndrome and not a herniated cervical disc. Do you know what your medical records say about your medical history, your carpal tunnel complaints, how your complaints are different because of the herniated cervical disc, or how they impact on your practice is different than your carpal tunnel symptoms?

 

Mass Mutual fights an individual disability claim as hard, if not harder than an ERISA claim and costly mistakes can be made at the initial application and appeal stages of a case.

Contact The Law Office of Nancy L. Cavey Today

 

Mass Mutual Financial Group has created a disability insurance guide for individuals and families entitled “Disabled? Me? Never!” Mass Mutual Financial group knows that if you couldn’t work, you are and your family would have difficulty in meeting its financial obligations including paying your mortgage, car payment, utilities, education, and living expenses. They provide a worksheet to help you determine whether or not you have the appropriate disability coverage you need and we applaud Mass Mutual for their efforts to help educate you regarding your needs. You can find this worksheet here.

 

Unfortunately, the claims process for Mass Mutual Financial groups is an education of a different sort. As they point out, “life is full of challenges.” Unfortunately, Mass Mutual disability claims handling only adds to “life’s challenges.”

 

If you are a Mass Mutual Financial Group disability insurance policyholder and are thinking about filing a claim for disability benefits or your claim has been delayed, denied, disputed, or even terminated, Mass Mutual Financial Group disability attorney, Nancy Cavey, can help. Contact us today for a consultation.