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“Aileen Murphy V. Deloitte & Touchee Group Insurance Plan” II

Aileen Murphy v. Deloitte & Touchee Group Insurance Plan”

Metropolitan Life Insurance Company

619 F.3d 1151(11th Cir. 2010)

We represented Aileen Murphy in her long term disability claim against MetLife. Ms. Murphy worked as a Tax Firm Director for Deloitte & Touche, a position which required travel, significant interaction and coordination with others, negotiations with the IRS, and advising clients in complex matters. She became disabled by co-morbid psychiatric and pain conditions as result of a severe back problem. The combination of her conditions together with her medications caused fatigue, balance and vision problems, memory and cognitive problems, as well as chronic pain. Her claim for long-term disability benefits was denied. She did her own appeal, which was also denied. We filed suit on her behalf in the district court and asked to conduct discovery regarding MetLife relationships with the doctors who provided reports for MetLife’s in Ms. Murphy’s case.

The district court denied the discovery and then ruled against Ms. Murphy.

We appealed. On appeal Tenth Circuit Court of Appeals held that the district court incorrectly refused to allow discovery regarding MetLife’s conflict of interest and ordered that we be allowed to be conduct discovery, appropriately circumscribed, to allow us to present evidence on the seriousness of MetLife’s conflict of interest and the likelihood it MetLife’s decision making process in Ms. Murphy’s case.

On remand from the Tenth Circuit, the case settled.

Insurance companies which both administer a plan and pay claims have an inherent conflict of interest. They are supposed to be the fiduciaries acting in the best interests of the claimants but, in fact, they often protect their own bottom line. It is important that claimants have the opportunity to conduct discovery to explore the nature, extent, and implications of this built-in conflict of interest.