Denes has dedicated the last 14 years of his professional life
to representing professionals against disability insurance providers
for payment of disability insurance benefits. Prior to that, Mr.
Denes represented disability insurance companies for some seven
years. In the 1980's disability insurers sold extremely beneficial
disability policies to attorneys, physicians and other professional
groups. Some of these policies were issued to members of various
professional organizations without evidence of insurability (i.e.
without considering the insured's medical condition). The policies
were marketed to provide total disability benefits to those who
could still practice in their profession, but who could no longer
perform specialty procedures (i.e. surgery, invasive cardiology,
trial practice) within their profession. The fiercely competitive
companies aggressively sold these policies to generate huge premiums.
the 1990's, however, the insurance companies saw a significant
increase in claims under their disability policies and began fighting
claims as aggressively as they had earlier marketed the policies.
As losses mounted on the disability claims, the companies fought
harder. Now, as a result of the number of claims and litigation
arising from those claims, there exists a significant body of
law surrounding individual disability insurance.
example, some Courts have indicated that a person becomes disabled
if he or she is unable to perform the duties of his or her occupation
in the usual and customary manner. That means that even if one
can continue to work in his or her occupation, a claim may be
made if an injury or sickness is causing him or her to perform
the same duties in an unusual or non-customary manner.
when a disability causes one to drop a portion of his or her practice,
he or she may be entitled to total disability benefits for the
reduction, even if income increases. Many companies are now challenging
payment of total disability benefits in favor of residual (or
partial) disability benefits.
companies are increasingly attempting to cancel or rescind policies
based upon misrepresentations made in the application. These cancellations
are generally sought after the insured has made a claim. However,
recent cases suggest that if the statements in the application
were made upon the "information and belief" of the applicant at
that time, coverage cannot be voided. Additionally, some policies
contain language which prevents the insurance company from canceling
the policy, even if an insured knew the answers in the application
to be incorrect.
insurance companies routinely seek to deny coverage when a condition
manifests itself before the policy went into effect. A denial
on this basis can be challenged in a variety of ways.
is imperative that anyone insured under a disability policy seek
experienced counsel, as the pitfalls in making and maintaining
a claim can have serious consequences. Gregory Denes has practiced
in the area of disability insurance law for twenty years, and
for seven of those years, his practice was devoted, in large part,
to representing disability insurers. That experience yielded incomparable
insight into both the legal and practical issues facing those
who file disability claims. Mr. Denes is available for consultations
by professionals who are considering filing a claim, whose claims
are pending and whose claims have been denied. Mr. Denes also
welcomes the opportunity to speak with insurance agents, consultants
and attorneys concerning their client's claims.