Individual disability policies have long been available to certain professionals, physicians, dentists and lawyers in particular. Sometimes individuals not professionals are prudent enough to purchase their own disability policies. Claims under such policies, like claims under professional association group plans or policies, are generally not governed by ERISA, and so pose the same risk of a bad faith claim accompanied by compensatory and punitive damages. Because most claimants are professionals and likely to be either legally or medically astute, these claims are subject to favorable resolution to a higher degree than the other three categories of claims. That is not to say, however, that one is not faced with the same problems of unreasonableness seen in the employer plan context in the handling of many such claims.
The disability and occupational benefit claims are of five basic types:
claims under employer group plans or insurance policies;
claims under employer occupational injury benefit plans or policies;
claims under professional organization group plans or policies;
claims under individual disability benefit policies; and
claims under municipal disability benefit plans. There are distinct legal standards applicable to each of such claims and the differing strategies and tactics for pursuing them.
There are several reasons why a consumer’s claim can be denied by an insurance company which could include the fact that a claim doesn’t fall within the scope of the insurance contract or perhaps the policyholder hasn’t complied within the policy’s terms. However, sometimes insurance companies that practice bad faith will deny a policyholder’s claim even if it is legitimate by failing to investigate claims or making the process of filling out paperwork more complex than it needs to be so a policyholder decides to drop the claim.
Most consumers who might encounter a denial are inclined to forfeit their fight because of the overwhelming frustration they feel pertaining to the denied claim. The Voss Law Firm, P.C. makes it easy for claimants to understand their rights and legal options. In addition to providing helpful counsel and a free consultation, clients have the option of receiving a free guide, which helps educate policyholders on what to look for regarding insurance bad faith, how to stay organized and motivated, and finally steps to take moving forward in order to get the money they may be entitled to - just ask one of our lawyers how to get your free copy. To learn more about disability insurance denial and how to take legal action if you believe your insurance company has acted in bad faith please contact us immediately.
Texas Insurance Code and Texas Common Law
Some insurance coverage, such as an individual policy or automobile policy, is not governed by ERISA and is instead subject to Texas law. The Texas Insurance Code and Texas common law provide several remedies for improper or bad faith insurance claim denials or misrepresentations made to sell insurance coverage.
- Health insurance claims
- Insurance coverage disputes and insurance policy litigation
- Disability claims
- Bad faith claim denials
- Employee benefit denials
- ERISA administrative appeals
- ERISA litigation
- AD & D claims
- Short-term disability (STD) claims
- Long-term disability (LTD) claims
- Life insurance claims
- Retirement benefit claims
- Automobile insurance claims