MetLife Life Insurance Claim Denial Cases: How Courts Are Ruling and What Beneficiaries Should Know
At our life insurance dispute law firm, we’ve seen firsthand how beneficiaries are often forced to battle insurance giants like Metropolitan Life Insurance Company (MetLife) in court just to claim the benefits they’re rightfully owed. MetLife frequently denies claims on grounds like misrepresentation, suicide, or exclusion clauses—often in questionable ways. Fortunately, courts across the country have been reviewing these denials carefully, and many have ruled in favor of beneficiaries who chose to fight back. Below, we share ten real-life MetLife life insurance claim denial cases, each shedding light on how these disputes unfold and what legal arguments can make a difference.
Case 1: No Proof of Accident – Court Sides with MetLife
After Verla Hancock died from an unknown cause, MetLife denied her daughter Terri Hancock's AD&D claim, asserting there was no evidence the death was accidental. Despite providing a detective’s report and her own account, the courts—including the 10th Circuit—upheld the denial. This case highlights the high burden of proof required in accidental death claims.
Case 2: Medical History Misrepresentation – Court Reverses in Beneficiary’s Favor
John Lee’s claim was initially denied after his wife Roberta Lee died of a heart attack. MetLife alleged she had concealed hypertension, diabetes, and obesity. Though the district court sided with MetLife, the 9th Circuit overturned the ruling, emphasizing that MetLife failed to prove the omissions were material and intentional. This shows that not all misstatements justify denial.
Case 3: Gunshot Death Ruled Suicide – Courts Side with MetLife
Patricia McCollum’s claim was rejected after her husband died of a gunshot wound, which MetLife labeled a suicide. Despite Patricia’s challenge, the district and 11th Circuit courts upheld the denial based on police and medical examiner findings. Suicide exclusions are enforceable when intent is clearly established.
Case 4: Drug Overdose Deemed Accidental – Denial Reversed by Appeals Court
When Michael Egan died of a drug overdose, MetLife denied the claim, arguing the death was self-inflicted. His mother Mary Egan sued. Although the district court dismissed the case, the 3rd Circuit reversed, finding that MetLife disregarded evidence suggesting the overdose was unintentional. Courts may side with beneficiaries when intent is ambiguous.
Case 5: Heart Attack and Alleged Concealment – MetLife Reversed for Arbitrary Decision
MetLife denied Sandra Glenn’s claim, alleging her husband David Glenn failed to disclose his heart-related medical history. The 4th Circuit overturned the district court’s summary judgment for MetLife, finding that the insurer acted arbitrarily and capriciously. This case reinforces that insurers must justify their denials with more than assumptions.
Case 6: Stroke and Hidden Health Conditions – Court Backs MetLife
Barbara Loughner’s claim was denied after her husband died of a stroke. MetLife cited nondisclosure of atrial fibrillation and other conditions. The 6th Circuit upheld the denial, affirming that William Loughner’s omissions were material and that MetLife had reasonably relied on medical records.
Case 7: Cancer and Omitted Medical History – Summary Judgment for MetLife Upheld
Susan Schuler was denied her husband Richard Schuler’s death benefit due to alleged failure to disclose melanoma, lung cancer, and brain cancer. Both the district court and 7th Circuit found that MetLife acted in good faith and that the misrepresentations were material, leading to a denied claim that withstood legal scrutiny.
Case 8: Beneficiary Designation Dispute – Court Sides with Widow
MetLife denied Doreen Abatie’s claim, stating that her husband Joseph Abatie had named his ex-wife as the beneficiary. The 9th Circuit reversed a lower court ruling for MetLife, holding that the insurer abused its discretion and finding that Doreen, as the current spouse, had a rightful claim. This decision shows courts can overrule strict beneficiary language when fairness and equity demand it.
Case 9: Heart Attack and Medical Omission – MetLife Prevails
Deborah Scharf’s claim for her husband Mark Scharf’s life insurance was rejected over nondisclosure of diabetes and coronary disease. The 2nd Circuit upheld the denial, finding the misrepresentations were material and that MetLife acted reasonably.
Case 10: Pulmonary Embolism and Omitted Health History – Dismissal Reversed
Linda Nickerson’s claim was denied when MetLife asserted her husband failed to disclose a history of deep vein thrombosis and anticoagulant use. The district court dismissed her case, but the 8th Circuit reversed, ruling that MetLife acted arbitrarily and capriciously and that the omissions were not material to coverage.
What These Cases Show Us
MetLife, like many large insurers, often denies claims using broad or vaguely interpreted exclusions and alleged application misstatements. However, courts won’t always accept these justifications—especially when:
The insurer fails to prove material and intentional misrepresentation
There is ambiguity about intent in suicide or overdose deaths
Beneficiary disputes hinge on outdated or unclear designations
The insurer fails to conduct a thorough and unbiased review of the claim
Our Firm Helps Families Challenge MetLife Claim Denials
We fight back when insurers deny claims unfairly—whether through ERISA lawsuits, bad faith claims, or state contract law. If you’ve been denied a MetLife life insurance claim, we’ll review your case at no charge and determine whether legal action is warranted.
FAQ
Can MetLife deny a claim due to misrepresentation?
Yes, but only if the misrepresentation is material and intentional. Courts often overturn denials when the insurer cannot prove this.
Are all drug overdoses considered suicide under a MetLife policy?
No. Courts may rule that the death was accidental if there's no clear evidence the insured intended to die, especially in cases involving prescription medications.
What happens if the beneficiary listed on the policy is no longer valid?
If the beneficiary is deceased or there is a conflict (e.g., a former spouse still named), the court may determine the rightful beneficiary—especially when the policyholder’s intent is clear.
Is MetLife required to investigate claims thoroughly?
Yes. Failure to properly investigate or fairly consider evidence can lead courts to reverse a denial for being arbitrary or capricious.