Warren Richey, writing for the Christian Science Monitor has an article on an interesting issue being taken up by the U.S. Supreme Court: Do insurers have a conflict of interest where they both evaluate and pay medical disability claims?
Do such companies operate in a conflict of interest between caring for their policyholders and enriching their shareholders? If such a conflict exists, how rigorously should federal judges examine decisions to deny benefits?
. . .
Because of her condition, the woman, Wanda Glenn, was found to be “totally disabled.” She began receiving disability benefits. She also followed her physician’s advice and a treatment program, and her health began to improve. When these improvements were reflected in her doctor’s reports, MetLife cited the reports and withdrew the benefits. The company said Ms. Glenn was not totally disabled and could find sedentary work.
The insurer says that its more efficient to have the tasks under one company and that separating the tasks will cause premiums to rise and benefits to be less generous. But, the woman’s lawyer has the better line: “When an umpire bets on the outcome of a game he is refereeing, he has a conflict of interest.”
Leave a Reply