ERISA

When an insurance company denies a claim for benefits, claimants often feel that they have no one to turn to for help.  Michael Horrow and his disability insurance team at Donahue & Horrow have the experience and knowledge needed to assist a claimant in receiving all of the benefits to which they are rightfully entitled.

Recently, Donahue & Horrow filed a lawsuit in Federal Court to help a client fight for disability benefits that they were improperly denied.

Our client was a Product Reviewer and Writer.  Unfortunately, in May 2023, because of restrictions and limitations imposed by a variety of conditions, including, but not limited to, generalized anxiety disorder, major depressive disorder, panic attacks, PTSD, binge eating disorder, and insomnia, he could no longer perform the material and substantial duties of his occupation.  Accordingly, our client promptly filed a timely claim for long-term disability benefits.

After reviewing his medical records, MetLife agreed that our client was disabled, and approved his disability claim.  Over the following months, our client provided MetLife with the documents and information the company requested.  These records supported his claim and demonstrated his continued entitlement to LTD benefits. 

However, in July 2025, MetLife suddenly denied his claim, yet failed to document any improvement in his overall condition.  MetLife’s claim decision was inherently flawed because the conclusion that our client was not disabled was based entirely on “paper reviews” of the medical records prepared by MetLife’s in-house, captured physicians.  The medical professionals on whom MetLife relied to support the claim decision never spoke with or examined our client.  Rather, their opinions were based solely on a review of medical records, which included the consistent conclusion that he was unable to continue working.  Unsurprisingly, MetLife decided to place the opinions of its employees above the opinions of our client’s treating physicians. 

Donahue & Horrow accordingly filed an ERISA lawsuit in the Central District of California in Downtown Los Angeles. Michael Horrow and his team will work to ensure that MetLife is held responsible for improperly denying our client’s claims for long-term disability benefits. If your long-term disability benefits have been denied under an employer-sponsored insurance plan, call Donahue & Horrow LLP at (877) 664-5407 for a free consultation.