WRAL Investigates

Woman wins 'inspiring' fight against insurance company

Posted August 30, 2010 6:00 p.m. EDT
Updated August 30, 2010 7:01 p.m. EDT

— 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.

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.