“”There is a cottage industry of doctors that do nothing but testify for “injured parties”. They don’t have to practice medicine; they just write reports and bill hefty fees which are gladly paid by plaintiff lawyers… “”
And on that same thought.
There is also a cottage industry of doctors that do nothing but testify for “Insurer’s”. They just write reports and bill hefty fees which are gladly paid by Insurers…
“”On the other hand the claimant has medical providers who are saying that she is disabled. What is the truth? Not likely to ever know. [[The claimant knows but it is *not* in her best interest to share the truth.]] And, isn’t that the tragedy of litigation in this arena—it is not in the best interest of a party for the truth to be known.””
…It would appear that *Yes* you are biased.
Your assumption appears to be that everyone is lying because the Truth would expose a Fraud.
What if the Truth is that she is truly disabled. And she is telling the truth because the Truth *is* in her best interest.
Or should see lie and say she’s fine?? That way you could believe her.
I agree that insurer’s should hold to the contract regardless of the situation. If in fact the claimant was still unable to perform the material duties of her job and had the applicable % loss of income she would not have been taken off claim. The Social Security eligibility is another issue entirely. The contract could have been off set by other income such as Social Security or had a definition requiring that the claim be denied due to eligibility for Social Security. Of course the insurer would help her to do this. I don’t think there’s any finger to magically point in any one direction here. Now the supreme courts get to decide; what is their expertise again?
In 1999 MetLife discontinued my disability benefits after I had received a confirmation of total disability from Social Security at the age of 59. I could not afford my mortgage, so was forced to sell my home near all my children while I pursued legal action against MetLife. I was awarded an out of court settlement of 199K, but more than half was paid to attorneys representing me. Also, in order to receive my award, I had to sign a waiver against any other pursuit against MetLife in this regard. I am no longer able to afford to live in the area near my children, but have moved to an area where I can afford to live. I am still devastated that I lost so much of my life during this process.
I admitted to a bias. But I do not admit to a prejudice. Anyone who doubts that there are many claimants trying to get their “lottery” payment from Insurance companies, is so naive as to be dangerous. Have you watched the commercials for any of the “TV Lawyers”? Guess who helps those claimants who want to expand their claim or perpetrate fraud.
I can’t say that I agree or disagree with Met Life in this instance, or any of the others so far adduced, because I don’t know enough about the evidence in the case. I can say, Donna, I really feel for you. You have had a terrible ordeal. I’m sorry to hear that your lawyers took most of the award, but I am not surprised.
Smitty, I agree that saying there is 90% fraud in any claim situation is probably an exaggeration. I would suggest that maybe what is meant that is that there is exaggeration 90% of the time.
It seems to me if you use the logic that the 6th Circuit is using, any insurance company (health, life, disability, home or whatever) has a conflict of interest when it comes to paying a claim and should not have the authority to adjudicate claims. That seems a bit stupid to me.
Using the same logic, P&C insurers are conflicted every time they make a claim decision on one of their insureds. Let the facts support the ruling – don’t assume insurers are the bad guy – that’s why claims satisfaction surveys are done. People can buy their insurance from whomever they wish.
We have updated our privacy policy to be more clear and meet the new requirements of the GDPR. By continuing to use our site, you accept our revised Privacy Policy.
Hey Wes,
“”There is a cottage industry of doctors that do nothing but testify for “injured parties”. They don’t have to practice medicine; they just write reports and bill hefty fees which are gladly paid by plaintiff lawyers… “”
And on that same thought.
There is also a cottage industry of doctors that do nothing but testify for “Insurer’s”. They just write reports and bill hefty fees which are gladly paid by Insurers…
Fred,
.
.
.
Well Jon,
Based on part of your comment… (brackets added)
“”On the other hand the claimant has medical providers who are saying that she is disabled. What is the truth? Not likely to ever know. [[The claimant knows but it is *not* in her best interest to share the truth.]] And, isn’t that the tragedy of litigation in this arena—it is not in the best interest of a party for the truth to be known.””
…It would appear that *Yes* you are biased.
Your assumption appears to be that everyone is lying because the Truth would expose a Fraud.
What if the Truth is that she is truly disabled. And she is telling the truth because the Truth *is* in her best interest.
Or should see lie and say she’s fine?? That way you could believe her.
Fred,
I agree that insurer’s should hold to the contract regardless of the situation. If in fact the claimant was still unable to perform the material duties of her job and had the applicable % loss of income she would not have been taken off claim. The Social Security eligibility is another issue entirely. The contract could have been off set by other income such as Social Security or had a definition requiring that the claim be denied due to eligibility for Social Security. Of course the insurer would help her to do this. I don’t think there’s any finger to magically point in any one direction here. Now the supreme courts get to decide; what is their expertise again?
Smitty,
90 % fruad…come on that has to be an exaggeration.
In 1999 MetLife discontinued my disability benefits after I had received a confirmation of total disability from Social Security at the age of 59. I could not afford my mortgage, so was forced to sell my home near all my children while I pursued legal action against MetLife. I was awarded an out of court settlement of 199K, but more than half was paid to attorneys representing me. Also, in order to receive my award, I had to sign a waiver against any other pursuit against MetLife in this regard. I am no longer able to afford to live in the area near my children, but have moved to an area where I can afford to live. I am still devastated that I lost so much of my life during this process.
I admitted to a bias. But I do not admit to a prejudice. Anyone who doubts that there are many claimants trying to get their “lottery” payment from Insurance companies, is so naive as to be dangerous. Have you watched the commercials for any of the “TV Lawyers”? Guess who helps those claimants who want to expand their claim or perpetrate fraud.
I can’t say that I agree or disagree with Met Life in this instance, or any of the others so far adduced, because I don’t know enough about the evidence in the case. I can say, Donna, I really feel for you. You have had a terrible ordeal. I’m sorry to hear that your lawyers took most of the award, but I am not surprised.
Smitty, I agree that saying there is 90% fraud in any claim situation is probably an exaggeration. I would suggest that maybe what is meant that is that there is exaggeration 90% of the time.
It seems to me if you use the logic that the 6th Circuit is using, any insurance company (health, life, disability, home or whatever) has a conflict of interest when it comes to paying a claim and should not have the authority to adjudicate claims. That seems a bit stupid to me.
Using the same logic, P&C insurers are conflicted every time they make a claim decision on one of their insureds. Let the facts support the ruling – don’t assume insurers are the bad guy – that’s why claims satisfaction surveys are done. People can buy their insurance from whomever they wish.