Thursday, March 3, 2011

Here are quotes from the U.S. Court of Appeals panel of Judges’ in the case of METROPOLITAN LIFE INSURANCE COMPANY
v. Russell D. CONGER, Defendant-Appellant.

"Such a decision-making process is not deliberate or principled, and the explanation provided was far from reasoned, as it failed to address any of the contrary evidence. Instead, MetLife supported its decision to rescind only by its cherry-picking symptoms from Conger's medical records, and then reverse-engineering a diagnosis. This is not the hallmark of a reasoned explanation."

 “MetLife reached its conclusion only by ignoring substantial contrary evidence in Conger's medical records. For instance, MetLife did not address the doctor's December 20, 1998 conclusion that Conger's "[b]rain demonstrate[d] no significant abnormality, [and was] essentially normal for patient's age," or the doctor's statement that he saw "no cerebellar abnormality." J.A. at 138. Similarly, Metlife ignored Conger's multiple brain MRIs that revealed no problems. MetLife's communications to Conger (through LTCP) do not acknowledge these MRIs or even attempt to explain why they do not negate its conclusion regarding Conger's condition. The same is true of the internal communications between LTCP and MetLife's claim-review physician. MetLife also ignored multiple neurologists' failure to diagnose Conger with a progressive neurological disorder or even to note an impression in their charts that he had such a disorder. Further, MetLife ignored Dr. Tillett's impression that Conger's ataxia was not "cerebellar," which indicates that Conger's symptoms were not caused by a neurological disorder.”

(End of quotes)

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