San Francisco and San Diego Disability Insurance and ERISA Claim Attorneys Fight Mass Mutual Claim Denials
If you have an individual or an employer-sponsored insurance policy and your claim has been wrongfully denied, you can trust in the attorneys at McKennon Law Group PC to fight to have your life, medical and disability insurance benefits reinstated. Our firm works on behalf of insured policyholders with wrongfully denied benefits claims and we exhaust every avenue to secure your benefits from life, general liability, long-term care and disability insurers like Mass Mutual. At our firm, we understand insurers like Mass Mutual better than anyone. McKennon Law Group PC’s attorneys, including its founder, Robert J. McKennon, have prior experience representing insurance companies before they started fighting insurance claim denials. We specialize in insurance claim denials under ERISA and state insurance laws. The combination of that experience and our dedication to results gives us the unique ability to get those life, long-term care and disability insurance claims paid.
Mass Mutual offers a wide variety of insurance products, including life insurance, disability insurance, long-term care and combined coverage for long term care and life. As to life insurance, Mass Mutual offers various types of coverage, including whole life, term life, universal life and variable life policies. Mass Mutual also offers employee benefits plans that include both insurance and retirement products. Mass Mutual was originally founded in 1851 and now its website boasts a substantial business: including $5 billion in benefits delivered to customers and $560 billion of life insurance protection in force.
Mass Mutual is a mutual company. That means it does not have shareholders. Instead, its members and participating policyowners are often described as sharing in the company’s ownership. This generally means that, if you’re insured under a Mass Mutual whole life insurance policy, for example, you are a member entitled to vote for the Mass Mutual Board of Directors. And, if you own that “participating policy,” you may be eligible to share in any dividends that Mass Mutual may declare. As a mutual company, it claims to operate for the benefit of its members and participating policyowners. In our experience, we believe that mutual insurance companies do a better job of paying claims than do non-mutual insurers. However, they still deny valid claims and we have a very successful track record against Mass Mutual.
Mass Mutual May Deny a Life, Long-Term Care or Long-Term Disability Insurance Claim in a Variety of Ways
If your claim has been denied by Mass Mutual, they might rely on any combination of the reasons discussed below:
- Mass Mutual might proclaim that the written proof you provided does not substantiate your claim for life, long-term care or long-term disability benefits
- Mass Mutual states that you supplied insufficient medical support
- Mass Mutual may underemphasize the amount of material you supplied in support of your claim, suggesting that the proof of loss is poorly documented or untimely
- Mass Mutual might investigate pre-existing conditions and determine your illness is excluded from coverage under the policy
- Mass Mutual may rescind your policy based on “materially false” statements made on the initial application you submitted
- Mass Mutual may use a third-party company to record and report on your daily activities, including any activity posted to social media and then it may overstate that evidence to deny your claim
- Mass Mutual may lapse a policy for nonpayment of the annual or monthly premiums, without providing proper notice to you
- Mass Mutual may expansively interpret an exclusion to its own benefit, and then deny coverage for the claim based on that self-serving interpretation
What Should Disability or Life Insurance Claimants Look for When Mass Mutual Denies a Claim for Life, Health, or Disability Insurance Benefits?
- Did Mass Mutual conduct a thorough investigation into all the potential reasons for coverage?
- Did Mass Mutual’s denial letter refer to clinical consultants physicians whose names you have never heard of before and have never treated you in person?
- If Mass Mutual properly pursued all the relevant medical information, did they then misinterpret those records or ignore or misconstrue medical evidence to deny your claim?
- Did Mass Mutual have an expert review your claim, but the opinion appears biased? Did the expert fail to review all of the relevant medical information? Did the reviewer ignore relevant medical evidence or mischaracterize the content of a conversation with your primary care doctor?
- Were you willing to subject to an in-person medical examination, with a doctor of Mass Mutual’s choosing, but Mass Mutual never scheduled an appointment?
- Did Mass Mutual ignore your illness, injury or other symptoms because it asserted that objective medical evidence does not support your claim? However, is subjective evidence the primary form of evidence with regard to your particular illness, such as mental disorders, autoimmune disorders, fibromyalgia and chronic fatigue syndrome?
- Did Mass Mutual improperly assert that your illness or injury is a pre-existing condition, wrongly attempt to rescind the policy or simply deny the claim with the intent of wearing you down?
- Did Mass Mutual improperly reach overstated conclusions in surveillance or social media of you engaging in activities as support that you are not totally disabled or can engage in the activities of daily living? Did Mass Mutual do so without properly considering or characterizing the actual duties of your occupation?
- Did Mass Mutual unreasonably fail to engage with you regarding what you needed to submit in order to adequately support your claim on appeal?
- Did Mass Mutual wrongly fail to acknowledge contrary findings of disability by the Social Security Administration?
- Did Mass Mutual attempt to contact your doctors and try to persuade them you do not qualify for policy benefits?
- Did Mass Mutual improperly rely on an exclusion in your policy to deny your claim?
- Did Mass Mutual incorrectly calculate your policy benefits or attempt to assert an benefit offset that does not apply?
If you have a wrongfully denied claim for disability, life, long-term care or other insurance involving Mass Mutual, contact McKennon Law Group PC and we will aggressively pursue your benefits
When your disability, life or long-term care claim is wrongfully denied, you need a skilled, experienced, focused and talented advocate to fight for you. If your claim for health, life, accidental death or dismemberment, short-term disability or long-term disability insurance has been wrongfully denied or suddenly terminated, fill out a free consultation form or call (949) 387-9595 to schedule a free consultation with the attorneys of the McKennon Law Group PC, several of whom previously represented insurance companies and are exceptionally experienced in handling ERISA and non-ERISA, bad faith insurance claims.