Individual Disability Insurance
Some people have disability insurance provided through their employer. If you have purchased a policy directly from an insurance company or insurance agent, then you have an individual disability insurance (ID) policy as opposed to a group policy. Your IDI policy was purchased by you to provide income protection if a medical condition or injury strips away your livelihood. Those purchasing IDI coverage include doctors, dentists, executives, lawyers, and other professionals. As a professional, you likely have been paying a hefty premium to your insurance company—for years or even decades—to protect the occupation in which you have succeeded only to find that your insurance company has not held up its end of the bargain. When insurance companies breach this promise by denying your claim, you have a claim for breach of contract and likely a claim for its breach of the duty of good faith and fair dealing impliedly owed to you as the purchaser of the contract. When this occurs, the insurance company has acted in “bad faith.” Your individual policy will be guided by the statutes and case law of your particular state. These state laws can differ. In Colorado, for example, a “bad faith” denial of your claim can lead to the recovery of extra-contractual damages, i.e. compensation for the harms caused by the denial beyond what is owed under the contract. Some states do not have these bad faith laws. Colorado also has a powerful statute (enacted in 2008) which may provide for a recovery of double the contract benefits and attorneys’ fees if the claim is “unreasonably delayed or denied.”
Know Your Policy
It is crucial that you read and your disability insurance policy. You need to understand the contractual provisions and claims process, preferably prior to filing a claim. Many IDI policies define disability as the inability to perform the material duties of the specific occupation you were in engaged in when you ceased work—referred to as “own occupation” policy. This type of policy insures your occupation as opposed to your income. You may even be entitled to the benefit promised under your disability policy if you are able to engage in some other occupation. Some of these professional policies, especially those purchased by physicians, may define disability as the specific medical specialty or even sub-specialty in which the doctor was engaged when the ability to do so was lost.
We offer consulting services to professionals who want to better understand their policy and the claim process before a claim is filed. IDI claims are often denied because the professional submitting the claim is inexperienced in insurance matter and generally unaware of the information to be submitted and how the claim process works. It is far better to be proactive during the claim process and document all communications. The attorneys at McDermott Law can help guide you through this process.
Fight a Denied Individual Disability Claim
If your disability insurance company has denied your claim, you need help from an experienced disability insurance lawyer. The attorneys at McDermott Law have the necessary experience to contest the denied claim, usually through the initial submission of an internal appeal to the insurer, and followed by litigation if the insurer continues to wrongly deny the claim. Through our extensive experience, we know what information is needed to support an effective appeal and the complicated legal issues that must be considered.
If you purchased an professional IDI policy and your claim is denied, the burden of proof is the same as a civil trial. This means you must show you are disabled by the preponderance of the evidence. You are allowed a jury trial, and may fully engage in evidence and discovery.
Our Individual Disability Insurance (Professional Disability) Attorneys are Available to Talk to You
If you have an individual disability policy and are thinking of filing a claim, and would like to have your situation reviewed in advance by an experienced disability insurance lawyer, feel free to contact us. Such reviews can typically be accomplished in a one to two hour paid consultation meeting. If you have already filed a disability claim, and it has been denied, you should not hesitate in having your situation reviewed by an experienced attorney. We have the experience it takes to understand your claim and guide you through the internal appeal process and to pursue your lawsuit against your insurance company if necessary. These consultations are often provide with no initial fee requirement.
Insurance companies will deny payment of your claim for a variety of reasons. The pursuit of a denied IDI claim can be overwhelming for many people who have lost the ability to successfully pursue their chosen profession If you have fallen victim to a disability insurance company, contact the individual disability and insurance bad faith attorneys at McDermott Law.
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