Whether you have disability insurance coverage through your employer or independently through your own personalized insurance coverage, you are entitled to receive disability benefits if you have a qualifying disability. Unfortunately, many insurance carriers avoid paying out benefits in full by making use of a number of strategies: delaying the processing of disability benefits (thus forcing the claimant to expend resources to obtain their rightful benefits), denying benefits, terminating existing benefits, underpaying disability benefits, or otherwise failing to act in accordance with their contractual obligations.
Here at Berg Plummer Johnson & Raval, LLP, our Houston disability insurance lawyers are prepared to negotiate with insurers and come to a resolution outside of the litigation process. If negotiation does not lead to positive results, we have the experience necessary to successfully litigate on your behalf.
Obligations Under Contract
Insurance policies can vary considerably. Your attorney will assess the insurance plan (and the language of the contract) and determine the obligations under contract — those that apply to you, the claimant, and those that apply to the insurer. Understanding the provisions and language of the contract,and how it will be enforced in practice, is critical. In some cases, insurers try to impose restrictive provisions on claimants to impede the claimant’s ability to receive benefits for their disability. For example, they may require a claimant to attend a medical examination hours away from their home. Failure to attend this examination can be deemed a failure to cooperate under the insurance policy.
Bad Faith Insurance Law
If an insurance company has denied your claim and your appeal does not succeed, then you may be entitled to sue them for wrongful denial and violation of the covenant of good faith and fair dealing that is implied in the insurance contract. The duty of good faith is important given that insurers are in a position where they have superior bargaining power and resources.
An insurer may be found to have violated their duty of good faith by engaging in the following wrongful conduct:
- Denying benefits without proper justification for such denial, given the evidence in the disability record
- Unreasonably delaying or otherwise withholding payment of benefits
- Violating obligations imposed on them by contract
- Terminating existing disability benefits prematurely
- Intimidating or otherwise coercing the claimant
Insurance contracts can be confusing, complicated agreements that contain provisions that many laypeople find impossible to understand. In many cases, insurance companies use this technical barrier to take advantage of claimants, not only by failing to resolve claims in accordance with their obligations under the contract, but sometimes by imposing restrictions on claimants that were not effectively communicated pursuant to the language of the contract.
At Berg Plummer Johnson & Raval, LLP, our Houston disability insurance lawyers are knowledgeable about insurers, disability insurance coverage plans, and how insurance companies process claims. Our attorneys are variously AV-rated, have been recognized as Super Lawyers, and have been named as among the Best Lawyers in America. We work closely with clients throughout the disability claim process, from the submission for disability benefits to appeal and all the way through to litigation, if necessary. Our attorneys have successfully litigated cases in state and federal court, at both the trial and appellate levels.
As our clients have varied budget constraints, we offer fee arrangements that are uniquely tailored to the needs of each client so as to ensure that we are able to cost-effectively achieve their strategic objectives.