Policyholders that have had their insurance disability claims denied have heard the same excuses. Ranging from failing to receive the disability claims documentation on time; failing to receive medical reports; ailment is not a covered disability and more. Insurance companies have historically refused benefits to policyholders or the insurance company alleges that the pain or ailment is not severe enough to prevent the employee from working. Recent studies on disbility claims have proven insurance companies wrong, yet benefit claims are still often initially denied, requiring a disability insurance attorney’s assistance to recover them.
Professional disability insurers have been found liable for denying coverage on claims brought by disabled professionals. In the 1970s and 1980s some of these insurers grossly oversold disability policies to younger professionals, anticipating that few claims would mount from this low risk population. However as the policyholders aged and professionals became disabled, the claims mounted steadily. Some of the companies decided to cope by unfairly denying claims to cut their losses.
Bad faith claims are a breach of the insurance contract, when insurers use non-legitimate reasons to deny disability claims. Insurers have a duty to the insured to examine claims in good faith and use fair dealing when evaluating claims. Bad faith claims require that the insurer make more than a simple mistake; instead, the insurer must engage in unfair dealings.
Most disability claim denial lawsuits involve action against an insured’s own insurance company, and arise in situations where the insurance company unfairly and without proper cause, fails to compensate the insured for a loss covered by the policy, or unreasonably delays making payments due under the policy.