Washington — Insurers that concurrently evaluate the merits of worker claims and pay the benefits were dealt a setback by the Supreme Court, In a 6-3 decision, the justices upheld a lower court’s ruling that it is fair to consider an insurance company's potential conflict of interest when reviewing the denial of an employee's health or disability benefits claim.
The case, Metropolitan Life v. Glenn, was launched by an Ohio woman who sued New York-based MetLife over a disability claim. The plaintiff, Wanda Glenn, contended insurers have a financial incentive to deny claims and that conflict of interest should be considered when benefit disputes end up in court. The Supreme Court decision upholds a federal appeals court decision that ordered Glenn's benefits reinstated.
Justice Stephen Breyer, writing for the majority, said federal law imposes a special standard of care on insurers requiring full and fair review of claim denials.
Source: Associated Press
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