Did Mass Mutual Deny Your Long Term Disability Insurance Claim?

Mass Mutual provides private and sometimes group disability insurance coverage.  Many times, this coverage is provided to doctors, dentists, and other medical professionals, offered early in their careers, with the ability for the coverage to expand as earnings grow.  

If your long-term disability insurance claim has been denied or terminated by Mass Mutual, you will need to prepare for a lengthy challenge. Mass Mutual is one of the bigger disability insurance companies, owned by MassMutual Financial Group. MassMutual is a diversified financial services company and offers a range of financial products, including group long term disability insurance policies offered as a benefit through employers and private or individual disability insurance policies, sold by insurance brokers and financial qualified financial advisors.

If you have a MassMutual long term (LTD) disability insurance policy, you did the right thing. A long term disability insurance policy is intended to protect you if you can’t work because of an illness or an injury. But the process of filing a disability claim with MassMutual and receiving benefits is rarely simple. The claims process requires you to manage a lot of paperwork and/or online forms during a time when you are also dealing with a debilitating illness or injury. Assembling all of the required documents for a disability claim while you are also processing health insurance claims is doubly difficult. 

A skilled long term disability insurance attorney is a valuable resource during this tough time. Disability attorney Jason Newfield has represented many people just like you, struggling to put together a complete disability claim with what seem like endless paperwork, managing calls and emails from a large insurance company that has nothing to lose, at the same time, fighting for your health and to protect your family’s lifestyle.

Common reasons for disability claim denials from MassMutual include:

Determining your claim lacks proper medical evidence. You may have submitted many reports, doctor’s notes, test results, lab work, and everything you can think of, hoping the sheer volume of materials would be sufficient for a claim approval, and yet MassMutual might still deny your claim. How can this be?

Claims are reviewed with several different goals in mind, none of which favor the claimant. First, the insurance company is looking to see if you have supplied sufficient medical proof of a disability. The proof may be denied if you have a specific condition, let’s say a chronic gastrointestinal disease like Crohn’s, and treatment is being provided by a general internist and not a gastroenterologist. 

Next, your medical records may have been reviewed by a nurse, nurse practitioner or doctor with no training in your specific illness. Your detailed reports on your Crohn’s disease could be subjected to review by a doctor who hasn’t seen a live patient in decades, as their entire practice is limited to reviewing documents selected by MassMutual claims managers.

Your medical records might also have been cherrypicked – bits and pieces sent to the reviewing person, who, lacking all of the correct information, might have come to the conclusion you are not disabled and able to work in your occupation. Without all of the information, they may have the best of intentions, but end up with the wrong conclusion.

While all of this is going on in the foreground, behind the scenes the insurance company is preparing for the possibility of having to protect profits in court. The information you provide and the responses you receive from the insurance company all are part of your file, which may be used if you appeal the denial and if necessary, if you need to go to court against MassMutual. 

Determining your work is sedentary and can be done while you have the disability. There are many occupations, particularly among the demanding professions like trading, CEO and CFO positions, logistics management and medicine, where the ability to concentrate and make quick decisions based on a large dataset and drawing on years of experience, is critical to performance. Someone who suffers from tinnitus, an audiological and neurological condition experienced by more than 25 million American adults, is not going to be able to function at the same high level as they did before becoming disabled. The ringing, buzzing, clicking, whooshing or other sounds in their ears that are not actually external sounds make it next to impossible to focus on anything, let alone tasks requiring high levels of cognition and executive functioning.

Jason Newfield has represented many claimants who have disabilities making it impossible to perform the duties of their occupation, but MassMutual denies their claim and states they are able to work. 

MassMutual Isn’t Paying my Disability Insurance Claim – What Can I Do? 

The Newfield Law Group has extensive experience filing and litigating disability claims for those whose long term disability insurance claims have been denied by MassMutual. We are familiar with the company, the types of insurance policies issued, the numerous riders often attached to the policies, and their strategies for denying claims. 

If your MassMutual claim has been denied, we invite you to call our office today at 877-406-7883 to speak with Jason Newfield, who can provide a free consultation about your claim. 

One of MassMutual’s strategies is based on their use of separate policy templates for each type of own-occupation coverage it offers. While the base policy usually defines total disability as the inability to work in your own occupation, many of these policies include a provision that limits your ability to collect total disability benefits only if you are not working. 

This is one of many reasons why disability attorney Jason Newfield recommends a consultation before filing a long-term disability insurance claim with MassMutual or any disability insurance company. There are deliberate pitfalls throughout the claims process that the layperson will not be aware of, often until it’s too late.  The contract of insurance is like the map to a treasure chest, and you must follow that map to ensure that you can qualify for benefits.

You Can Fight Back with a Disability Insurance Attorney

While you are not required to work with an attorney to file an appeal, your chances for success increase with the help of an experienced long term disability insurance attorney. MassMutual and other insurance companies have limitless resources, including lawyers, medical and vocational professionals, and other support staff to help in their job of denying claims. The odds of one person without experience or knowledge of the disability insurance field being successful against a huge insurance company are not great.

Consider contacting an experienced disability insurance attorney if MassMutual has engaged in any of the following conduct during your claim process:

  • Requested in person interview or field visit by a claims manager or claims investigator from MassMutual
  • Challenged or ignored your personal credibility based on your submissions in support of your valid claim for disability benefits
  • Relied upon nurse reviews or in house medical professionals to dispute your doctors’ opinions supporting impairment
  • Contacted your doctor without your knowledge or authorization
  • Requested that you attend a Functional Capacity Exam (FCE) or Independent Medical Exam (IME)
  • Could not completely understand your disability policy or your eligibility for benefits and tried to confuse you as to eligibility issues 
  • Requested volumes of paperwork (multiple times) and then advised the sought after information was never received by Mass Mutual
  • Failed to respond in a timely manner about your valid disability benefits claim, leading to delays in approving your disability benefits

SUCCESS STORY WITH MASS MUTUAL

Our client came to us with a denied claim from Mass Mutual, who refused to credit her ongoing symptoms of Lyme Disease, after she valiantly returned to work on a part-time and modified basis to continue to contribute financially to her family and try to maintain a career that she had created so much success prior to her illness.  She has worked for a financial company and was earning significant money in her field.  Despite continued evidence and the support of her doctors, Mass Mutual viewed her case as being subject to a mental health limitation in her policy, with broad contractual language to support its position.  

We brought the case to a resolution platform, utilizing a private mediator to work on the issues with the parties, in an effort to resolve the action prior to expensive and lengthy litigation that our client neither could afford nor had an appetite for.  In fact, she had no desire to have her name in public so she had advised the firm she would not pursue litigation.  We succeeded at mediation in providing a strong result for the client, getting Mass Mutual to resolve the disputed claim issues. To accomplish this result, we spent significant time working on mediation briefs (trial briefs) to influence the neutral third party to be compelled that our case was strong, to be able to advocate positions to get Mass Mutual’s business team to appreciate the legal exposure and spent a full day navigating the issues through a mediation session between the parties and counsel.  The client was happy to have certainty, and closure to her case, and was able to move on with her life and focus upon her health. 

Need Help with a MassMutual Disability Appeal? Call Newfield Law Group

Newfield Law group is committed to advocating for claimants, whether for short term or long-term disability insurance claims.  We have helped scores of people fight back for their benefits, holding the insurance companies to their coverage contracts and their promises.   Call our office today at 877-406-7883 and find out how we can help you with your issues and secure your long-term disability insurance benefits.