NAIC Weighs in on MetLife v Glenn

Written by: Nick Curabba

Hat Tip to Roy Harmon at the Health Law Blog for this interesting development in the MetLife v. Glenn case (about which we have blogged already).  It appears that the National Association of Insurance Commissioner (NAIC) has decided to weigh in on the upcoming MetLife v. Glenn case pending before the Supreme Court. 

A link to the NAIC brief is here. 

As the organization responsible for representing the interests of state insurance regulators, you can be sure the NAIC argues strenuously for the Supremes to rule in favor of a strong conflict of interest standard when an insurance company both acts as a claims administrator and benefit payor. Mr. Harman quotes Montana state auditor John Morrison as saying:

Our position is that insurance companies evaluating claims that they will have to pay always have a conflict of interest . . . Their denials definitely should not be given more weight than the evidence of workers and their employers that claims should be paid. 

Among other things, the NAIC brief proposes one way to deal with the conflict is to prohibit the use of insurance discretionary clauses all together, a position they have made clear with the formulation of the Discretionary Clause Model Act.  It remains to be seen how much deference the Court will accord the NAIC, but we think their brief makes arguments that will be hard to ignore completely.