Employers often offer life and accidental death insurance as a benefit to their employees. However, in spite of having policies and procedures that must be followed, an insurance company may find itself having to defend those same procedures when an insured is either denied payment or tires of often unavoidable delays. Many of these companies conduct business in New York.
Recently, Metropolitan Life Insurance Company filed a petition of removal to have a case moved from the state court to federal jurisdiction due to the provisions that cover the employee retirement and welfare benefits. The lawsuit was recently filed by a parent whose daughter worked for AT&T/DirecTV at a call center in her state. After she was let go from her position, she died from an allegedly accidental substance overdose a short time afterwards.
At the time of her employment, she purportedly had coverage for both life and accidental death insurance, which was provided through MetLife. According to the plaintiff, he and the deceased woman's mother were named sole beneficiaries of her policies. As such, he sought information from her former employer regarding any benefits due after her passing. According to his account, his inquiries regarding coverage were passed back and forth for several months, with both the insurer and employer sending him back to the other party.
The claim for benefits has not been formally denied, though a representative for AT&T responded on one occasion that the employee did not have coverage and that the claim was the responsibility of the insurance company, though later he was told to deal with MetLife directly. At this point, the plaintiff's suit asserts that the lack of official response is effectively a denial of benefits. New York companies are entitled to a comprehensive and thorough defense when they are facing these situations as many customers may not willingly accept a legitimate denial of benefits and could take their complaint to court.
Source: wvrecord.com, "DirecTV life insurance benefits lawsuit removed to federal court", Kyla Asbury, May 17, 2017