A recent case out of the USDC of Sourthern New York was won by plaintiff Tracy Solomon. Ms. Solomon was granted LTD benefits from her plan with MetLife.

One of the highlights of the case was the relationship of the medical reviewer with MetLife. Dr. Amy Hopkins was hired my MetLife to be an independent medical reviewer and to determine if Ms. Solomon was disabled. The decision to terminate benefits was based largely on Dr. Hopkins' report that Solomon was able to work. Solomon contested the validity of Hopkins as an independent medical reviewer due to her close ties with MetLife. Upon further review it was found that Dr. Hopkins earned well over half of her income from doing independent medical work for MetLife. The judge determined that this was a relationship that went beyond what is acceptable for a reviewer to be regarded as "independent."

The inherent bias of having to determine disability payments from your employer casts doubt on the validity of Dr. Hopkins' opinion. In the cutthroat world of insurance, companies favor those doctors who give them the best chance at legitimate denial. With such a vested interest in maintaining a relationship with MetLife, her largest beneficiary, the possibility of bias and the solid medical evidence that contradicts Dr. Hopkins' opinion is enough to determine that her report is flawed. This judge set it right, let's hope others follow suit and insurance companies learn to use legitimately independent doctors. Here's the entire Solomon v. MetLife opinion .
Ben Glass
Connect with me
Ben Glass is a nationally recognized car accident and ERISA disability attorney in Fairfax, VA.
Be the first to comment!
Post a Comment