"Instead of recognizing the patently obvious Congressional intent, the ERISA courts have contrived ersatz administrative procedures, with an inlay of trust law, for the judicial review of denials of ERISA benefits. This court has learned to live with its disappointment."
The court raise the question of whether, in light of the Supreme Court's ruling in MetLife v. Glenn, 554 U.S. 105 (2008), courts should allow claimants to conduct limited discovery to ferret out conflict of interest evidence and information about procedural defects. Judge Acker did not resolve that question because he found that based on information in the record, without discovery, MetLife had abused its discretion in denying Blankenship's disability benefits.
One aspect of MetLife's decision-making process that bothered the court was MetLife's reliance on file reviews, without examining the claimant, to deny the claim. "Most hired hands don't go contrary to the boss's best interest. Paid experts, more often than not, are, in this court's experience, 'predisposed' or 'preconditioned' . . . The fact that MetLife relied on mere file reviews, especially when the reports re in direct conflict with opinions rendered by Blankenship's own treating physicians and with the Social Security Administration's ultimate, if belated, determination, are facts that weigh in favor of a finding that MetLife's denial decision was the culmination of a structurally conflicted process."
A final aspect of the decision that is worth comment is its last paragraph. The decision was issued on December 30, 2009. The parties apparently settled the case thereafter on condition that the plaintiff would agree with the defendant to jointly ask the court to withdraw its December 30, 2009, Memorandum Opinion! This maneuver produced the following terse comment by the court:
"The court has before it an oral motion by defendant, Metropolitan Life Insurance Company, in which plaintiff, Frank Blankenship, joins. it was communicated to the court by telephone to a law clerk. The parties seek a vacation or withdrawal of the opinion of December 30, 2009, as amended, in consideration of Metropolitan Life Insurance Company's agreement not to appeal. The motion, if not contemptuous, is unlike any motion ever submitted to the undersigned during his twenty-eight years on the bench. It is DENIED."
- ?I have been awarded Social Security disability benefits. But the insurer of my disability policy has denied my claim. Can the insurer do that?
- ?I already have a lawyer working on my social security disability claim. Can't that lawyer handle my disability insurance claim too?
- ?What issues do you see in life insurance claims?
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