Many workers have disability insurance from MassMutual Financial Group in order to have protection if they are disabled and unable to return to their jobs. MassMutual will sometimes deny valid disability claims, but you do have the right to appeal the company’s decision. The experienced legal team at Osterhout Berger Disability Law is here to help you with your appeal of the denial from MassMutual.
In This Article
Founded in 1851, MassMutual Financial Group has more than 10,614 employees and five million customers around the world. In 2016, the company had $29.6 billion in revenues and was ranked as number 76 on the Fortune 500 list. MassMutual sells a variety of insurance products, including life insurance, long-term care insurance and disability insurance. It also sells retirement and 401(k) plans, annuities and other financial products.
MassMutual sells short- and long-term disability insurance products. The company’s policies pay disabled workers between 45 and 65 percent of their former incomes. The duration of the payments will depend on the provisions of an individual’s policies. Short-term disability payments are available following the completion of an elimination period for short durations while you are unable to return to work. If you also have long-term disability insurance, those payments can begin once your short-term benefits end. The duration of long-term disability benefits may be multiple years.
Short- and long-term disability insurance from MassMutual helps cover a percentage of your salary in the event you become disabled and are unable to work. This could be extremely helpful while you’re in the process of recovering. Electing to have both short- and long-term disability insurance can be even helpful as you’re covered for a longer period of time. However, you’re going to want to be aware of a few items that may be in your policy. Your employer may require you to go through a waiting period. This means that you may have to wait a certain amount of days before you can request to get benefits from your disability insurance. Typically, employers choose to have a 90 day waiting period, but your employer may choose to make it shorter. Once you go through the waiting period, you’ll be eligible to request benefits.
If you find yourself in the position where you need to request benefits from MassMutual, you’ll have to go through an elimination period. Most insurance companies require you to go through a period between the time you’re disabled until the time you can start receiving your benefits. This period can be anywhere between 30-365 days. You may be able to choose your elimination period or your employer may choose it for you, so just make sure that you’re aware of the length of this period. You’ll also want to check to see what MassMutual defines as a disability. The insurance company may consider certain illnesses and injuries to be pre-existing and won’t define those as disabilities that make you eligible to collect benefits. You’ll want to pay close attention to this as this may put you in a tough spot if you ever find yourself unable to work for a period of time.
Whenever you’re ready to submit a disability claim to MassMutual, you’ll want to make sure that you fill out the paperwork completely and accurately. A lot of insurance companies tend to use any missing or inaccurate information against claimants by delaying or denying their request for benefits. Sometimes insurance companies will work with the claimants by requesting more and more information, but most times that’s just another tactic to delay the claim from being processed. So, the most important thing you need to do in order to avoid delay or denial is to make sure you have each section of the form filled out.
Disability claim forms require three sections to be filled out: the employee’s statement, the employer’s statement, and the attending physician’s statement. There may also be authorization forms, but those just require signatures. The most challenging part is going to make sure that your employer and attending physician return the completed paperwork in a timely manner.
Once the forms are all complete, you can either mail or email the forms in or you can even complete the forms over the phone. If you do choose to fill the information out over the phone, MassMutual will still have to mail the forms to you to get your signature. The insurance company claims that you will be contacted by a claim examiner within ten business days of the insurance company receiving your claim notice. Make sure to ask the claim examiner any and all questions you may have about the forms and process.
If you feel like the process is delayed, it’s important that you contact your claim examiner. They should be able to present you with a logical answer as to what’s causing the delay. However, they may come back with more questions that you need to answer and claim that they need more paperwork from you in order to move the process along. If this is happening to you, then you may to seek out the help of an experienced disability lawyer. They can help you move the process along.
MassMutual notifies claimants of its decision to deny their claims by sending letters to their homes. This letter will contain some important information, including the reasons that the company is relying on to support its denial, how to appeal the decision and the deadline that you have for doing so. You must use the company’s appeals process. The law doesn’t allow you to head straight to court without first exhausting the company’s internal remedies. You must also file your appeal within the stated deadline or you may be prevented from ever recovering the benefits. After you receive your letter, call the company and ask it to provide you with a copy of your file. Inside, you will find all of the evidence on which the company relied to deny your claim. If you don’t win the appeal through the insurance company’s appeals process, you’ll then be able to fight it in court. An experienced disability lawyer at Osterhout Berger Disability Law is willing and able to help you fight the denial.
When you come to Osterhout Berger Disability Law, one of our experienced disability lawyers will want to review your file and your letter. He or she may then make recommendations to you about what to do to increase your chances of winning your appeal.
When you are working with your lawyer, it is important for you to follow through with the recommendations that you are given and to always be honest about your condition. Some people stop going to their doctor because they feel like nothing can be done. If you are not seeing your doctor, however, MassMutual may believe that you are not truly disabled. Your lawyer may want you to also get additional tests and exams. The more evidence that you can gather to support the basis for your claim, the likelier that it will be for you to succeed on your appeal.
Some people also make the mistake of exaggerating about the symptoms that they are experiencing in the belief that doing so will help their claims. MassMutual is very good at uncovering evidence showing that people are being dishonest about their symptoms. If you are dishonest, the company will use your exaggerations as evidence that you are simply malingering, which can be fatal to your claim and appeal. For help with your appeal and advice about your rights, contact the knowledgeable disability lawyers at Osterhout Berger Disability Law today.