Wrongly Denied Disability Claims

There has been a trend in complaints from individuals who allege that they have been wrongly denied payment of legitimate disability claims or were granted disability payments that were later terminated.

Disability Income Insurance is sold as a form of coverage that should pay people a weekly or monthly income for the period of time a worker is declared disabled by an accidental injury or illness. Insurers have routinely and historically denied benefits to policyholders, even when claims have been legitimate. The insurer may allege the pain is not severe enough to prevent the insured from working, even when several professionals have attested to the opposite. Recent studies have shown this to be true, yet benefits are often initially denied and often require the help of an attorney to recover their justifiable insurance awards.

Unfortunately, it appears that many policyholders are given the same excuses as to why their claims are being denied. They range from technicalities like failing to obtain certain documents on time, claims of non-receipt of required medical reports, or the particular ailment is not a "covered" disability, and so on.

In numerous cases, professional liability insurers have been found fully liable for denying coverage on claims brought by disabled individual and groups. For example, in the 70's and 80's insurers oversold disability policies to young professionals. However, young professionals eventually become older professionals, and they suffer the same illnesses and disabilities as the general population. Yet their claims were almost always initially denied, as a tool to preserve the finances of the companies who sold the policies. When taken to court in this matter, the insurers were found liable for breach of contract.

In essence, bad faith claim denials are a breach of the insurance contract, especially when insurers use bogus and less than legitimate reasons for denying claims. Insurers have an ethical and legal duty to examine claims in good faith and to be fair when making claim determinations. Acting in bad faith means the insurer must be willfully engaging in unfair practices, it has to be more than an administrative error.

Most legal actions arise when the insured is forced to sue their own insurance company when cases occur where the insurer is denying coverage unfairly and without proper cause. The failure to pay the insured for a loss covered by the policy or unreasonable delays in making payments due under the policy are the most common grounds for a lawsuit claiming bad faith and wrongfully denied disability claims.

Register your Denied Claim Complaint

If you or a loved one has been Denied Disability, you may qualify for damages or remedies that may be awarded in a possible class action lawsuit. Please click the link below to submit your complaint and we will have a lawyer review your Insurance complaint.

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