At Disability Insurance Law Group, our national claims attorneys know that, according to their online profile, “With 153 years of experience, MetLife is a leading innovator and a recognized leader in protection planning solutions worldwide. Our name is recognized and trusted by tens of millions of customers worldwide, and we do business with 96 of the top 100 FORTUNE 500® companies in the United States.”
While MetLife’s profile is impressive, it can be intimidating to those seeking disability benefits from the corporation. Unfortunately, the process often does not stop at intimidating. Disability insurance is designed to provide income if a worker cannot perform their work due to disability. While they are working through the challenges associated with being unable to work because of their disabling condition, being met with resistance to accessing their benefits can be overwhelming.
For many U.S. workers, their employers offer disability benefits as part of their employment packages. This is especially true for most group policies governed by the Employee Retirement Income Security Act of 1974 (ERISA), millions of which MetLife underwrites.
The key differences between an ERISA disability and a private disability insurance policy lie in their regulatory framework, the entities offering them, and the legal protections they afford to policyholders.
To follow is a breakdown of the distinctions:
ERISA DISABILITY POLICY
ERISA sets standards for establishing and operating employer-sponsored benefit plans, including disability insurance.
ERISA disability policies are typically provided as part of an employer-sponsored benefits package. Employers often purchase group disability insurance plans for their employees.
ERISA imposes specific legal requirements on employers providing disability benefits, including disclosure obligations and procedures for filing claims and appeals. It establishes a set of rules and standards to protect the interests of plan participants.
ERISA preempts many state insurance laws, which can impact the legal remedies available to policyholders. ERISA disability claims are subject to federal law, and there are limitations on the types of lawsuits that can be filed in state courts.
ERISA disability claims are often subject to a “deferential” or “arbitrary and capricious” standard of review by the courts. This means that, in legal challenges, courts may give deference to the decisions of the plan administrator unless those decisions are found to be unreasonable.
PRIVATE DISABILITY INSURANCE POLICY
Private disability insurance policies not part of an employer-sponsored plan are regulated by state insurance laws. These laws vary by state and may include requirements related to policy language, consumer protections, and claims handling.
Private disability insurance policies can be purchased individually by individuals who want coverage outside or in addition to employer-sponsored plans.
While state insurance laws provide specific protections for policyholders, the legal framework for individual disability insurance is generally less standardized than ERISA. Legal remedies and standards can vary by jurisdiction.
Unlike ERISA disability claims, which are typically litigated in federal court, private disability insurance claims may be filed in state courts, allowing policyholders to pursue legal remedies under state laws.
Legal challenges to denials of private disability insurance claims may be subject to a different standard of review, meaning the court reviews the claim without giving deference to the insurer’s decision.
It’s essential for individuals to carefully review the terms and conditions of their disability insurance policies, whether ERISA or private, and understand the legal framework that applies to their specific coverage. We can help.
Whether you are considering applying for benefits, are waiting for a claim’s decision, or have been denied, we can assist you with your MetLife disability claim anywhere in the country, starting with a free consultation.
We are fully dedicated to providing transparent legal services that allow us to pursue real results for real people who need our help – no matter where they live or work in the U.S.
If you are receiving resistance from MetLife for your U.S. disability claim, or if your claim has already been denied, contact our dedicated disability insurance attorneys nationwide at 954-989-9000 or online to schedule a free, confidential case assessment without delay.
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