At Riemer Hess, we have a strong track record of helping clients secure their long term disability benefits from MassMutual. As a significant player in the disability insurance landscape, MassMutual is known for its meticulous approach to assessing disability claims. Many individuals turn to us when they encounter challenges with MassMutual, whether their claims have been denied or their benefits unfairly terminated.
Below we’ll delve into the unique tactics MassMutual employs to deny disability claims and discuss effective strategies to overcome these tactics.
What common tactics does MassMutual use to deny disability claims?
MassMutual, like many insurers in the ERISA arena, often employs tactics in disability claim assessments that can be viewed as heavily skewed in favor of the insurer, to the detriment of claimants. These tactics may include:
- Biased medical reviews: There’s a concerning trend where MassMutual heavily leans on medical reviews conducted by physicians who might have a contractual bias towards the insurer. These reviews often critically analyze the claimant’s medical records and can conclude that the medical evidence is insufficient to support the claim, even when the claimant’s personal physicians have presented a different view.
- Unreasonably questioning claimant credibility: MassMutual often delves into the claimant’s personal life, including social media and financial activities, to challenge their credibility. This invasive tactic can be seen as an attempt to find any possible reason to refute the claimant’s stated medical condition, implying a presumption of dishonesty on the part of the claimant.
- Selective reliance on Functional Capacity Evaluations: The use of Functional Capacity Evaluations, particularly for high-income professionals, can be a double-edged sword. While ostensibly a tool to assess the claimant’s physical capabilities, there is a concern that MassMutual uses these evaluations to unfairly accuse claimants of malingering or exaggerating their conditions. These evaluations may not always accurately reflect the claimant’s condition.
- Minimizing cognitive impairments: If a disability claim involves cognitive impairments, MassMutual may downplay their impact and argue that the claimant can still perform tasks despite evidence suggesting otherwise.
- Interpreting “Total Disability” narrowly: MassMutual’s approach to defining “total disability” under their policies often appears to be excessively rigid and skewed towards limiting payouts. This interpretation can lead to situations where claimants, despite being unable to perform their job duties due to their medical condition, are denied benefits due to narrow contractual definitions that favor the insurer’s interests.
These tactics can create an environment where claimants may feel that the deck is stacked against them, necessitating vigilant and aggressive advocacy from ERISA attorneys to ensure a fair and just assessment of their claims.
What strategies work best against MassMutual?
When navigating the complexities of a disability claim with MassMutual, particularly under ERISA regulations, certain strategies prove essential for a successful challenge. These approaches are designed not only to counteract the insurer’s denial tactics but also to reinforce the legitimacy and strength of the claim. Each of these strategies plays a vital role in building a comprehensive and persuasive case against the denial of benefits.
Several effective strategies against MassMutual can be employed, including:
- In-depth understanding of your policy: It’s crucial to thoroughly understand the specific terms and conditions of your disability insurance policy. This includes understanding how the policy defines “disability,” the requirements for proof of loss, and any limitations or exclusions that might apply. A comprehensive understanding of these details can provide a strong foundation for challenging any claim denial based on policy terms.
- Supporting your claim with robust medical evidence: Gathering comprehensive and robust medical evidence is key. This includes detailed medical records, diagnostic test results, and physicians’ statements that clearly outline the extent of your disability and its impact on your ability to work. Strong medical documentation can counteract any attempts by MassMutual to downplay or misinterpret the severity of your condition.
- Consult independent experts: In addition to medical evidence, consulting independent experts can be highly beneficial. This might include independent medical examinations, third-party Functional Capacity Evaluations (“FCE”s), and vocational assessments. These independent evaluations can provide objective evidence about your physical or cognitive limitations and counter any biased assessments used by MassMutual.
- Consult with an experienced ERISA Attorney: Engaging an experienced ERISA attorney is critical. These attorneys specialize in navigating the complexities of ERISA law and can provide strategic guidance throughout the claim process. They can assist in gathering and presenting evidence, communicating with MassMutual, and, if necessary, litigating the case in court. Their experience in ERISA claims and the specific tactics used by companies like MassMutual is invaluable in effectively challenging a claim denial.
These strategies can help create a strong case against MassMutual’s denial of disability benefits. They address the key areas where insurers typically focus their denial efforts and ensure that you are well-prepared to contest any unfounded denials.
How can Riemer Hess help with my MassMutual long term disability claim?
Riemer Hess has helped many clients successfully secure their disability benefits from MassMutual. With our extensive experience in handling disability insurance claims, we’ve developed a deep understanding of MassMutual's tactics in administering claims. This familiarity positions Riemer Hess well to anticipate and counter MassMutual's approaches, leveraging our insights and experience to effectively advocate for our clients’ rights under ERISA and related disability insurance matters.
Here's one example of how we’ve helped a client against MassMutual’s tactics:
“Sarah,” a brilliant IT project manager, suffered a life-changing Traumatic Brain Injury (“TBI”) in a car accident. The TBI left Sarah with significant cognitive impairments, making it impossible for her to continue her demanding job. Sarah initiated her disability claim with MassMutual, equipped with extensive medical records and support from her neurologist. However, MassMutual still challenged the severity of her cognitive impairments.
MassMutual insisted on Sarah undergoing a comprehensive neuropsychological evaluation. Sarah was nervous about undergoing the evaluation because the expert was hired by Mass Mutual. Sarah knew that the expert could be biased. After attending the evaluation, Sarah felt there was a strong chance that the report could be unsupportive of her claim.
Recognizing the need for legal expertise, Sarah sought the assistance of Riemer Hess. To counter MassMutual’s report, Riemer Hess obtained opinions from independent neurologists and neuropsychologists who concurred with her treating neurologist, reinforcing the legitimacy of her claim. Together, they emphasized the profound impact of her cognitive limitations on her ability to perform her job.
MassMutual conducted a thorough review of Riemer Hess’s arguments and the compelling evidence presented. As a result, despite the biased and unfavorable report from their own expert, MassMutual granted Sarah the long term disability benefits she rightfully deserved. Relieved, Sarah retained Riemer Hess to monitor her long term disability claim going forward.
MassMutual employs a diverse array of tactics that require vigilant attention and skilled navigation. Facing the challenges presented by MassMutual can be a complex journey, but it’s a journey you don’t have to undertake alone.