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About Denes Law Disability Insurance

Disability Insurance

Greg 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.

In 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.

For 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.

Additionally, 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.

Disability 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.

Finally, 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.

It 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.