Attempting to do your job, albeit really incompetently, does not prevent the collection of benefits under an own occupation disability insurance contract if the cause of your incompetence is your medical condition. Own occupation disability insurance protects the insured against the inability to perform his or her chosen profession. These policies were written in the 70’s, 80’s and early 90’s and protect an insured if he is unable to perform the principal duties of the occupation he was performing when he became disabled as a result of a sickness or injury. It is irrelevant if the insured professional can do other types of work or earn income in some other capacity. Our firm has touted the benefits of this type of insurance over the years because it is the best money can buy, and it really protects professionals when they can no longer pursue their chosen occupation because of a medical condition. Claims under own occupation disability insurance policies are highly scrutinized by disability insurers attempt to avoid their obligations.
Consider a case from several years ago of a New York City plastic surgeon who was addicted to drugs and suffered from Bipolar Disorder – Jacobs v. Northwestern Mutual Life Insurance Company. Even though Dr. Jacobs was in a fog and under the influence of drugs, he continued to treat patients until his medical license was suspended. He made a claim under his own occupation insurance policies with Northwestern Mutual Life Insurance Company, but the company refused to pay claiming he continued to work as a surgeon and only stopped because he had his license yanked.
Acknowledging the value and meaning of own occupation disability insurance, a New York Appellate Court gave the surgeon a complete win without the necessity of a trial. The court determined that a professional like Dr. Jacobs may be at work every day of the week, but if he is not performing at his pre-disability capacity, he is entitled to be paid his disability benefits. In his case, failure to perform his occupation competently as a result of a mental health condition satisfied his burden of proving total disability.
Because so much money is at stake, professionals with claims under own occupation disability insurance will likely meet resistance and unfair tactics by disability insurers.
Gisonni Law Firm focuses its practice on disability claims and litigation for the disabled in New York, New Jersey and the tristate area. For an understanding of your legal rights from the perspective of a highly experienced disability attorney, call Gisonni Law Firm today.