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John Legal
John Legal, Attorney
Category: Legal
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Experience:  Over 15 years legal experience.
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My wife has MS. Twelve years ago she became unable to work

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My wife has MS. Twelve years ago she became unable to work and went on LTD with MetLife. After a time she was told to apply for Social Security. She did so, and after one appeal was placed on SS. MetLife informed us that they would reduce her monthly premium by the amount of SS benefit she was receiving at the time, and because of the appeal and later approval, we were to pay back approx. $6700 to them as an "overpayment". Fine. We did so and received a thank you letter for clearing up the problem. We have received the same disability payment from MetLife for ten years now. In Feb. 2011, my wife received a request from MetLife to review her SS records, we assumed that they were looking for income from other sources. As she is truly disabled and has no other income, we did not hesitate to grant permission.

On April 26, 2011 we received a letter from MetLife advising us that they had been overpaying us $61/month (dating back to the date of the first adjustment) for twelve years. We "owed" them approx. $12,000, $6000 had been paid in the first adjustment, with a balance of $6000 due. We called the number on the letter for explanation, and we're told that this was "strange". Now they have withheld her check that was to be paid on April 29, 2011.

I have all of the documentation from 12 years ago setting the amount of MetLife's monthly obligation, I have the original adjustment letter, I have the thank you letter for paying the adjustment. My questions are: 1) is it legal to make an "adjustment" after so long a time, 2) can they withhold the entire disability check in an attempt to recover funds, 3) what is our recourse?
Submitted: 5 years ago.
Category: Legal
Expert:  John Legal replied 5 years ago.

Thank you for asking Just Answer,

I would call the insurance commissioner in your state. There is something very strange about this. For them to go back so many years and adjust payments when they had all of the social security information previously seems incorrect.

It is hard to tell if they can do this if the money was truly overpaid by MetLife but I would generally think their contract for insurance with your wife says they can.

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