MetLife Denial Upheld Because Disability Claim Filed Outside of Statute of Limitations

Dr. Beatriz Martinez began working for the Familyconsiderable reduction in pay.
Health Care Centers of Southwest Florida (FHC)Martinez’s disability insurance attorney first
as a physician. Her contract with FHC began inrepresented her case against MetLife before the
early November 2001 and extended throughU.S. District Court for the Middle District of Florida.
November of 2003. The contract required FHC toThis court found that the case was time-barred
provide long-term disability insurance as a benefitby the statute of limitation included in the policy
of employment. She had only been with FHC forlanguage.
a month when she suffered a grand mal seizure.Her disability lawyer then represented her
It was at this time that a brain tumor waslong-term disability claim before the U.S. Court of
discovered. Martinez underwent surgery. She wasAppeals for the Eleventh Circuit in Atlanta, GA.
finally able to return to work in Feburary, 2002,MetLife Wins Case Because Statute of Limitations
but it soon became apparent that her health wasRan Out
continuing to deteriorate. She was unable to fill herThe Court of Appeals reviewed the record and
role as a physician, so FHC reassigned her to asided with MetLife. Using the most generous dates
position where she provided bilingual healthpossible, the Court found that Dr. Martinez’s
education. She held this position until April 2003,claim was filed with MetLife four months too late.
until working became impossible.The Statute of Limitations Begins Ticking on the
Employer Cancels Disability Insurance Policy withDay of Demotion.
MetLife.Disability insurance policies contain complex and
Meanwhile, FHC had cancelled its policy withconfusing contractual language that disability
MetLife. When Martinez filed a disability claim withattorneys take years to become experts at
MetLife one year later in April 2004, MetLIfeinterpreting. MetLife’s inclusion in the disability
denied her claim. They provided three reasons forpolicy language of a one year time limit to filing
doing so:disability claims was shorter than the statute of
1)MetLife claimed that her coverage didn’tlimitations generally recognized for insurance claims
become effective until after her brain seizure. Thein Florida. Courts consistently uphold the shorter
disability insurance provider considered the braintime limits in disability insurance policies. In order
tumor a pre-existing condition which would not befor Dr. Martinez to have won her disability claim
covered by the disability insurance policy language.based on her demotion from physician to
2)MetLife pointed to Martinez’s last day ofeducator, she needed to file her claim within one
work. It fell after FHC cancelled the disabilityyear of that date. Instead, she filed her claim one
insurance plan with MetLIfe. 3)MetLife consideredyear after she left work permanently.
the last day that Martinez worked as the firstHire a Disability Insurance Attorney Early.
day of her disability.You must remember that disability insurance
Martinez appealed MetLife’s denial, but thecompanies seize any opportunity they can to
appeal paperwork disappeared.deny a claim for benefits. They aren’t going
Disability Attorney Supports Claim.to remind you that an important deadline is
Martinez’s disability lawyer supported hercoming up. You will get one notice at the most.
contention that she had a claim. She disagreedSeeking a disability attorney to guide you through
with MetLife’s starting date for coverage. Shethe challenging process of applying for disability
believed it began with the date she began workinginsurance and appealing a disability claim denial or
for FHC. She also felt that under the language ofdisability insurance termination can make the
the policy, her disability actually began when shedifference between receiving the benefits you
was forced to downgrade from a physician to adeserve and being wrongfully denied.
health educator, as this had precipitated a