Despite many professionals collectively spending millions annually on disability insurance premiums, many insurers still find ways to unfairly deny their coverage. One of these tactics is resorting to insurance code violations.
State insurance codes or statutes regulate unfair insurance trade practices, and provide efficient legal remedies to those who were unfairly denied disability benefits from an individual disability policy.
Each state sets forth insurance codes or statutes to regulate trade practices in the business of insurance, by
- defining or providing for the determination of trade practices that are unfair methods of competition or unfair or deceptive acts or practices in the business of insurance;
- establishing the statutes of limitations for violations;
- prohibiting those trade practices; and
- providing efficient legal remedies to those whose legal rights were violated under the code.
Common Insurance Code Violations
Examples of violations committed by insurance carriers include,
- breach of contract
- bad faith insurance dealings
- using unfair methods of competition and deceptive practices in the business of insurance,
- withholding a fair settlement as required by state insurance code
- failure to make prompt payment of a disability claim
- failing to give reasons why benefits were denied or terminated
- misrepresenting the policy as providing rights and remedies that it does not provide
- making false statements of material facts, not meeting required time demands as required in the code
- falsely and knowingly stating the claim is governed by ERISA law
- misrepresenting statements about a policy issued or to be issued, regarding policy terms, and benefits promised by the policy
- false or deceiving statements regarding the financial condition of an insurance carrier
- through misleading or confusing statements, cause an insured to let a policy lapse or to forfeit the policy
- calling a policy by a title that does not reflect the true nature of the policy
There may be times when another legal action such as statutory bad faith, breach of contract or deceptive trade act violation may also overlap or mesh with a states’ insurance code violations. It is important that your attorney knows and understands the applicable statutory regulations.
Relief for Denied Claims under Insurance Code Violations
An experienced disability insurance lawyer will uncover and prove those acts that violate state insurance statutes. According to your state’s insurance code, damages available may include:
- Up to three times the amount of actual damages
- Court costs
- Attorney’s fees
Attorneys for Individual Disability Policy Denials
Insurance carriers are resourceful in the strategies they use to deny long term disability insurance benefits. Marc Whitehead & Associates helps medical professionals across the country obtain relief and recover damages for any harm they suffered due to insurance Code violations.
If your claim for disability benefits has been unfairly denied or terminated, we welcome your call to learn how we may assist. We understand the difficulties you face as professionals and business owners. Our attorneys and staff are committed to protecting your rights and strongly believe that insurance corporations should be held to their word.
An insurer’s devastating wrongful claim denial can be overturned. Your remedy is to sue them and make them pay. Call 800.562.9830