WRAL Investigates

Woman wins 'inspiring' fight against insurance company

Posted August 30, 2010

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— A Warrenton woman nearly lost all she had when the company that provided her long-term disability benefits decided to stop paying. Insurance customers like her haven't had the legal legs to stand on to get back their benefits – until now.

Gloria Williams' court case caused ripples in the insurance industry, quickly showing up on insurance news wires and websites.

Williams used her hands to make a living typing. Those same hands led her down a painful, legal nightmare.

“My hands hurt me so bad that they swell up, and it’s like someone’s sticking pins and needles in my hands,” she said.

Williams was diagnosed with carpal tunnel syndrome and went on long-term disability through MetLife insurance. After 18 months, MetLife said stopped paying. That's when she decided to fight.

“I’m a person that when I know somebody did me wrong, I’m determined to make it right,” Williams said.

After researching on the Internet and talking to lawyers from as far away as California, Williams submitted a handwritten civil lawsuit against MetLife. Along with her lawsuit, she submitted a traced picture of her hand documenting the scars from nine hand operations.

From Raleigh's federal courthouse to the federal appeals court in Richmond, her case took more than five years to settle – five years that took a toll on Williams.

“I got so stressed," she said. "I told my sister ‘I can’t do it anymore. I’m just tired. I can’t do it anymore.’ That same night I went into a coma."

Doctors said they think the stress triggered an alarming rise in Williams' blood sugar. After five days in a diabetic coma, she woke up and started to fight again.

Woman wins fight against insurance giant Woman wins fight against insurance giant

North Carolina Insurance Commissioner Wayne Goodwin deals with thousands of insurance complaints every year. He said he knows it can be daunting to face off with a big insurance company, but says Williams' case should serve as an example.

“It’s actually inspiring, encouraging. I’m glad that we had someone like her who did put her foot down and fought on this,” he said. “Some folks give up, but I hope this is an example of what they should do. And that’s not give up.”

After five years of fighting – the coma, a bankruptcy filing and almost losing her house – Williams got the news of her landmark win. In one of the few cases of its kind, a federal appeals court ruled MetLife improperly cut off her benefits.

“I was determined that MetLife had no right to deny my disability. I wanted a judge to tell me if I was right or wrong. And I was right,” she said.

One of the court's biggest issues with MetLife is that it paid the disability as well as determined if it was even needed. There was no independent review of Williams' medical conditions.

As it turns out, the MetLife doctor who recommended canceling Williams' payments did so based on a medical evaluation of her neck, not her hands.

Williams did receive back pay from MetLife, and her coverage was reinstated.

People who find themselves in a similar situation should save all their paperwork and call Goodwin’s office, the insurance commissioner said.

23 Comments

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  • Deep Thought Aug 31, 2010

    No party.....Yes carpal tunnel can be abused but mine (and I'm retired so no one to try to cheat) was determined by a test done on my hands by the doctor. The test showed I needed surgery on my right hand but my left wasn't so bad. I don't believe that test could be easy to cheat on since it had something to do with measuring the electrical impulses in the nerves. (Yes, I know the doc did the wrong body part for her)

    It's nice that you could state that her coma was caused by "stress along with bad eating habits and no exercise was probably the cause." instead of saying 'possibly'

  • rhess2 Aug 31, 2010

    Good for Gloria Williams standing up to an insurance company. It appears from the article that she went pro se representing herself in court with the advice of lawyers. While State Insurance Commissioner Wayne Goodwin said "Williams case should serve as an example", I can't help but wonder why the Agency didn't sue on her behalf? Often it appears that agencies in NC that offer consumer services do not have the teeth and/or willingness to step up to the plate, at times even when laws are being breached.

  • wildcat Aug 31, 2010

    She won the fight against the insurance company and that says a lot. Many people would not have bothered. But she went all the way.

  • wildcat Aug 31, 2010

    Good for her.

  • No Party Affiliate Aug 31, 2010

    "carpal tunnel syndrome" Is this really a issue? I know many try to get on disability with this excuse.

    Feel bad she went into a diabetic coma but stress along with bad eating habits and no exercise was probably the cause.

  • rfred16 Aug 31, 2010

    Had to comment on one last post....."they keep raising your rates for nothing"....Have you checked out the cost of prescriptions lately? How about a surgery, office visit, or band-aide? Guess not....you probably just pay your copay and don't think about the true cost of that service. The costs of healthcare go up close to 10%-15% per year....and you wonder why premiums increase on health insurance? How about that $60,000 claim on my dad's surgery, or his $125,000 claim on repairing his house......he could pay premiums for 5 lifetimes and never make that up. He used to complain about insurance companies too.....but not any more. Take a minute and check out the profit margins of health insurance companies.....You will find they are in the middle to low end of any industry...

  • rfred16 Aug 31, 2010

    Wow...you people are way off base. I guess it is true that all you hear complaints from are the 2% that have had a problem. Well, here is the view from the 98%. I have had nothing but great experiences with my insurance, and one of them is MetLife. We have their dental and disability coverage and have had several employee claims that were handled well. My dad, with another insurance company, had his house struck by lightning and they put him and my mom in a nice hotel for 2 months while they completely replaced the inside walls, flooring, etc. Their house looks brand new and the company was great to work with. Then, there was his $60,000 bypass, that was all paid less his deductible with no hassle. You need to realize the "insurance companies" that you so love to hate, are made up of employees, people, just like you and me. Yes, they try to make a profit, but what company doesn't?

  • Pseudonym Aug 31, 2010

    imyourhighness69,

    I fail to see how this is a Liberal v Conservative issue. This is an issue about somebody being cheated out of a service she paid for.

    OTOH, if she were on Government assistance, she would have lost. And paid dearly for it.

  • delilahk2000 Aug 31, 2010

    INSURANCE COMP. ARE NOTHING BUT CROOKS AND THEIVES, YOU FILE A CLAIME AND THEY DROP YOU FOR USING WHAT YOU PAID FOR. THEN THEY KEEP RAISING YOUR RATES FOR NOTHING.....

  • delilahk2000 Aug 31, 2010

    GREAT JOB.

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