Own Occupation Disability Claim Denial

New York Disability Insurance Attorney Representing Clients With Own Occupation Disability Income Insurance Policies

In the 70’s, 80’s, and 90’s, a handful of disability insurance companies sold disability insurance policies to high income earning professionals with the promise of coverage should they be unable to work in their chosen occupation. Doctors, lawyers, stockbrokers and business owners bought these non-cancellable policies in droves expecting that insurance companies like Provident Life and Casualty Insurance Company, The Paul Revere Life Insurance Company, First Unum Life Insurance Company and The Equitable Life Assurance Society of the United States, to name a few, would honor their promises and pay benefits should these professionals become disabled someday. These policies had attractive features like lifetime benefits, annual cost of living increases to benefits as high as 7% and occupational specialty clauses.  If the orthopedic surgeon could no longer perform surgery because of disability but could still be a general physician, these insurers promised they could still work as a physician and be paid disability benefits which were often tax-free.

The Reality of Own Occupation Disability Income Insurance Policies

While the fixed premiums for these Cadillac of policies were not cheap, for professionals whose earnings increased in successive years, it was a worthwhile financial investment to buy up more coverage over time. What the purchasers of these policies could not anticipate though was that the disability companies that sold them would eventually realize that they oversold them at premiums far too low.

As time went on, the original insurers sold the book of business of these own occupation policies to other companies or changed their company name. So when claims started coming in and this book of disability business caused big losses, this new generation of disability insurers and third party administrators obligated to pay benefits such as UnumProvident, Unum Group and Disability Management Services did what insurance companies do best — they denied claims.

Insurance Companies’ Unfair Termination Tactics

And they employed the most creative and deceptive ways to get around paying truly deserving people who paid their premiums for years.  Consider an eye surgeon whose own eyes failed because of early onset macular degeneration; the stock trader who was no longer steady on her feet because of multiple sclerosis; the accountant who could not calculate figures because of cognitive dysfunction.  These high income earning professionals’ claims were targeted for denial by unscrupulous disability insurers that employed unfair tactics to deny, terminate or shorten disability claims.

Termination tactics and bad faith administration patterns employed by disability carriers became commonplace in own occupation disability claims and it was not too long before long term disability carriers that provide group disability coverage to companies for their employees modeled their claim administration models after those money-saving examples.

Contact Gisonni Law Firm

If you have been denied a claim for your own occupation disability income insurance policy, you need effective representation to fight for your future. Gisonni Law Firm prides itself in serving the interests of disabled insureds facing insurance companies that won’t pay. If you need quality legal advice and effective representation, contact Gisonni Law Firm for a consultation.