Unfair Insurance Tactics

Experienced New York Insurance Claim Attorney Fighting for Victims of Unfair Insurance Tactics

People trust that insurance companies are ready to help when needed most. Though we pay into a multitude of policies, including disability insurance, life insurance, own occupation insurance, and more, filing a claim can be a complicated process sometimes. Insurance companies are “for-profit” and that means limiting or denying payouts whenever possible. Under some circumstances, insurance companies will engage in some unfair tactics to limit their responsibility. If this has happened to you, your rights may be violated and you need an attorney as soon as possible. Gisonni Law Firm, P.C. has been a legal resource for the insured for many years. If you need our help, contact our firm for a consultation.

Claims of Insufficient Proof

Making a disability claim can be a frustrating process.  While you are going to medical appointments and trying to find medications that work, you are asked to complete paperwork, have your physician complete paperwork and submit it all within short deadlines identified by your disability insurer. More

Cherry-Picking Medical Information

Disability insurance companies are expert cherry-pickers. All disability claims involve the disabled insured turning over medical records or giving authorizations for the insurer to get the records. Medical records are the most important part of a claim because they support the proof needed to show that the insured can’t perform their occupational duties. More

Inappropriate Requests For Information

One of the most frequent questions clients have is whether their disability insurance company is overstepping its bounds when requesting information from them.  The answer is found in the insurance policy language.  What you will find is a section that discusses proof of loss, and it is pretty vague.  Some policies outline specific documents insureds have to turn over but most don’t. More

Inappropriate Care Accusations

When we purchase a disability insurance policy, we hope that the insurance company’s goal is to ensure a bright future that was stripped away by your sickness or injury. Unfortunately, insurance companies often do not have their customers’ lives in mind when they need to file a claim. Because insurance companies are “for-profit,” they will employ unfair tactics to limit payments to their customers, even denying claims completely. More

Denying Lifetime Benefits

Some companies sold private disability policies that paid benefits for his lifetime if the insured’s disability is caused by an accident.  If the disability was caused by a sickness, benefits are limited to age 65.  In order to get around paying lifetime benefits, some unscrupulous insurers attempted to paint an accidental disability as one that arose from a sickness. More

Interference With Your Physician Relation

Disability insurers frequently seek to have telephonic communications with a disabled insured’s physicians.  The reason they claim it is necessary is to clarify information in the medical records.  Often what actually happens is inappropriate interference with the physician-patient relationship. When customers file claims for disability, they do not think their insurance company will go out of their way to deny them support. More

Forcing a Claim Into ERISA

If you have a privately-purchased disability income insurance policy and you receive a claim denial or termination letter from your disability insurance company that refers to the Employee Retirement Income Security Act or “ERISA,” you should be alarmed. Insurance companies often use unfair tactics to limit customer’s benefit payments after a claim filing. If you believe that your insurance company is claiming that your policy is governed by ERISA in order to limit its obligations, you need to consider your legal options. More

Forcing Residual Disability in a Total Disability Claim

A bad faith tactic employed by disability carriers is to treat a lifetime total disability claim as if it is a residual disability claim to shorten a disabled insured’s claim to age 65.  Some private individual disability policies offer a partial monthly benefit when a disabled person can still perform some work but sustains a loss of income because of his medical condition. More

Surveillance and Investigations

Nothing raises the hair on a person’s neck more than the prospect of an insurance company following her around and photographing and videotaping her activities. You immediately feel like you are doing something wrong even when you’re not. Insureds rightfully view surveillance as a complete violation of their privacy. More

Targeting Claims for Termination

If you have been receiving disability benefits from a company and it starts to feel like the company is pushing you into a claim termination, your claim may have been targeted for termination.  When the insurer is putting undue pressure on you or your physician to get information back to them quickly when before you had a longer time, beware. This is just one example of conduct by a disability insurer that smacks of targeting your claim for termination. More

Beware of the IME

After you file your claim, often your disability insurance company will send you a letter telling you to go to a medical examination by a physician they chose to examine you.  Insurance companies call it an IME or Independent Medical Examination, but it is far from “independent.”  They hire the doctor; they pay the doctor; the doctor makes a good living from doing these exams; and some companies even try to get the doctor to change the draft report to sound more favorable to the insurance company. More

Mental Health Disability Claims

If you suffer from a mental health condition and are under the care of a mental health professional, do you have to turn your confidential records over to the insurance company?   When you discuss your feelings, it is expected that you will freely share information to assist in the assessment and treatment process.  During those communications, you could share highly personal information with your treating practitioner that you may feel is simply no one else’s business. If your disability insurance company wants all of your communications with your therapist or psychiatrist, contact Gisonni Law Firm to discuss your rights. More

Residual Disability Claims of Business Owners

Business owners such as accountants, physicians, dentists, and shop owners who own private disability income insurance can receive disability benefits under their policies if they are still at work, they can still perform some, but not all, of their work duties, and they suffer an income drop.  Companies that currently administer these types of claims attempt to wiggle out of all liability by misconstruing business owners’ duties and misunderstanding the business owners’ financial records.  If you are disabled and making a residual disability claim, seek out the advice and counsel of Gisonni Law Firm. More