In Feb 2012 MetLife cancelled payments on my disability insurance policy and we have been fighting them ever since.
Perhaps I’m naïve, but I never thought for a second this would be part of my fight. Each of my Doctors wrote 4 letters, my home Nurse, Nikki, even my mother wrote letters of support. In his letter to MetLife, one of my Doctors wrote “In my opinion, Mr. Kaferly is the most severely disabled patient I’ve treated in my 42-year medical career”.
I have found out the hard way that the truth is MetLife’s only goal is to deny at all cost. No matter how overwhelming the evidence, no matter how overwhelming the scope of damage and disability is. Deny, deny, deny…
Even though MetLife is my “fiduciary” – which means they’re bound by law to put my interests ahead of theirs – my life is a “business decision” to them. They know that they don’t have to accept the evidence or statements from my Doctors or caretakers. The ERISA laws that govern this dictate that worst thing that will happen is a Judge will yell at them and tell them to pay what they owe. There are no penalties to MetLife for doing this, no matter how egregious their abuse of power is. Why should they do the right thing? Meanwhile, for the last 3 years we have been unable to afford care or treatments of any type. We can’t even afford co-pays, utilities, proper food, etc.
This is the ugly truth of the business of Disability Insurance. No matter how obvious, overwhelming and/or heavily substantiated your claim is, you will be denied at some point. I’ve learned this is not unique to my situation. But I believed in human compassion and fairness. I never thought for a second they could or would do this, it defies all reason. My faith tells me that there’s a ‘special’ place for people like them.
If there ever was a definition of “disabled”, my story is it. This affects me globally, as an organism. You can see my list of symptoms – pick a category and that’s more than enough to disable even the most determined person. The pain alone is enough. This goes far beyond pain and far beyond anything I ever imagined could possibly happen to the human body.
My condition has deteriorated significantly since they stopped the funds I used for treatment and living expenses. They don’t care, it’s just business. While I understand and fully support their need to investigate claims to eliminate fraud or to stop people from taking unfair advantage, I simply cannot understand their need to risk peoples lives in the name of profit. My disability is severe and unquestionable, and they know it.
We filed a Federal lawsuit against MetLife to restore my benefits. Our lawsuit can take up to 18 months to resolve. It will hardly be a big win. Even when we had benefits being paid, we could only afford minimal care and treatment as the treatments for mitochondrial disorders are generally not covered by insurance. But it was at least possible to get some of the care I require.
While MetLife plays games to find ways to not pay and protect their bottom line, my son has to watch his father waste away.
I will update this portion of my fight as it develops.