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Success Stories

Why You Need a Lawyer Before Filing an LTD Claim by Evan Schwartz

{3:40 minutes to read} Many years ago, before 1995, a professional could file a long-term disability claim on their own and likely get paid. After 1995, the industry changed dramatically. Many companies went out of business in the long-term disability space, claims were being denied and terminated like wildfire, and litigation spawned all over the country on a massive basis; a huge industry shakeup happened.

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Why You Need a Lawyer Before Filing an LTD Claim

High Scrutiny of Long-Term Disability Insurance Claims by Insurance Companies by Evan Schwartz

{3:30 minutes to read} Filing a claim for long-term disability benefits is an exhausting and complicated process—especially in the early stages. Professionals need to be wary of what this process entails in order to be prepared and ensure that their claim is approved.

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High Scrutiny of Long-Term Disability Insurance Claims by Insurance Companies

Trigger of Insurance Coverage: A Basic Primer by Evan Schwartz

{4:35 minutes to read} When you buy a policy and transfer risk to an insurance company in exchange for payment of a premium, the incidents, events, or circumstances covered by your policy are called triggers of coverage. The trigger of coverage depends on the type of policy you have. 

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Trigger of Insurance Coverage: A Basic Primer

Waiver of Premium Benefits Under Your Insurance Policies by Evan Schwartz

{2:53 minutes to read} Did you know: In addition to the Waiver of Premium benefits under your long-term disability policy(s), other policies may contain a Waiver of Premium provision? You may be entitled to Waiver of Premium benefits under a number of insurance policies. 

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Waiver of Premium Benefits Under Your Insurance Policies

What Did Sandy Teach Us about the Flood Exclusion? by Evan Schwartz

{2:25 minutes to read} Recent storms such as Sandy and Irene have proven that the Northeast is extremely vulnerable to major flooding. They also made many people aware that most homeowners’ and business owners’ insurance policies have something called a flood exclusion.

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What Did Sandy Teach Us About the Flood Exclusion?

Under the Microscope: Examination Under Oath by Evan Schwartz

{4:48 minutes to read} An examination under oathor EUO, as we call it in the businessis a tool that’s been in the insurance company arsenal for a hundred years. The concept arose to help insurance companies investigate suspicious claims and the potential for fraud, usually involving property or liability claims.

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Under the Microscope: Examination Under Oath

An Insurance Company’s Duty to Defend (Part 1) by Evan Schwartz

{5 minutes to read} There are a few things that you, as the insured, should know when the insurance company hires a lawyer on your behalf. 

For liability claims that are covered by insurance, businesses and individuals have two types of protection:

1. The insurance company will hire and pay a lawyer to defend the insured when a claim is covered or potentially covered by the policy. 

2. The insurance company will pay, or indemnify, the insured up to the limits of the policy’s indemnity limit that was purchased (the coverage limit). 

For example, you have a million dollars in coverage. A lawsuit is filed against your business that has exposure of up to a million dollars. If the insurance company believes the claim may be covered, they will provide you with a lawyer to defend you. The insurance company will then pay to settle—or go to trial and pay up to one million dollars if a verdict is awarded against you. 

In almost all policies, the insurance company has total control over the defense and settlement under the policy. So you, as the insured, have a lawyer who is hired to represent you, but the insurance company will ultimately make the determination of the defense strategy and amount of money the lawyer can spend/bill to defend your case properly. The insurance company will also decide whether the case should be settled and for how much. 

The insurance company has a lot of control in that situation. That doesn’t change the fact that the lawyer is hired to represent you or your business. The lawyer is not hired to represent the insurance company. The lawyer has an absolute, ethical duty of loyalty to protect you. 

The ethical obligations of the lawyer-to-client relationship don’t change simply because an insurance company is footing the bill. 

In part 2, we will look at the ways in which the lawyer must abide by—in respect to the lawyer-client relationship. Feel free to contact us to discuss any aspect of these potential problems.

Evan-Schwartz

 

Evan S. Schwartz
Founder of Schwartz Law
800-745-1755
ESS@schwartzlawpc.com

An Insurance Company’s Duty to Defend (Part 1)

When Insurance Companies Refuse to Settle Your Liability Claim: Do Not Fall Victim to Third-Party Bad Faith by Evan Schwartz{5:40 minutes to read} Insurance is synonymous with protection. As individuals or in our roles in organizations, we trust insurance companies to protect our interests in the event of a liability claim.

Insurance companies are supposed to treat their policy holder’s interests as they do their own. When an insurance company does not do so and leaves you exposed and damaged, you may have a claim against them; This is known as a third-party bad faith claim.

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When Insurance Companies Refuse to Settle Your Liability Claim: Do Not Fall Victim to Third-Party Bad Faith

Our client had been a Senior Vice President for a French bank. He worked on Wall Street in New York, supervising all of the bank’s financial trading worldwide. He was diagnosed with a brain tumor and resigned from his job.

He filed a claim under his disability policy with a major disability insurer. The company approved the claim and paid monthly for nearly 10 years. After finding out that the client owned an internet based collectibles trading business, the insurer terminated the claim and sued for a $3 million refund. The insurer alleged that the claim should never have been approved and it sought a court ruling that there was never a disability.

We were hired, and we fought back hard. We counter-sued, seeking a declaration that a refund could not be obtained and that the client was disabled.

An intense re-investigation of the case was commenced and pursued by our firm. We questioned top officials of the insurance company under oath in the lawsuit and revealed many weaknesses in the insurer’s allegations.

After fighting numerous battles and cross-examining the brain surgeon experts hired by the disability insurer, we set up a mediation process to discuss settlement. We got the insurer’s CEO to personally sign off on a settlement in which the insurer dropped its $3 million case and paid our client $4.25 million in a buyout lump-sum settlement.

Schwartz Law is the premier disability insurance law firm in the United States. To see how we can help you, contact us.

$4.25 Million Settlement: And They Wanted Our Client to Pay Them a $3 Million Refund?
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Testimonials

  • When I came to see Evan Schwartz, I had already shut down my business, was in the midst of a horrible divorce, had no income and hadn’t even filed a

    Business owner
  • Evan Schwartz and his team of lawyers fought for me like no one has ever for fought for me before. After a series of bad experiences with both doctors and

    IT Director
  • As a dentist with a private practice knowing I had no choice but to file a long term disability claim, hiring the right law firm was one of the most

    Dentist
  • As Vice President of a large brokerage firm, I did anticipate having a problem with Hartford Insurance Company and, for that reason, I was advised to apply for long term

    V.P. Brokerage Firm
  • Dear Michail: I just received the box containing my copy of the appeal you sent to the insurance company. To say I was overwhelmed would be a complete understatement. My

    Financial Services Manager

Latest Blog

Why You Need a Lawyer Before Filing an LTD Claim

{3:40 minutes to read} Many years ago, before 1995, a professional could file a long-term disability claim on their own and likely get paid. After 1995, the industry changed dramatically.

Read More...
Pursuing A Bad Faith Claim Against Your Insurance Company

{3:20 minutes to read} An insurance company engages in bad faith when it unreasonably denies, delays, terminates or underpays your claim. For example, if the insurance company refuses to pay for

Read More...
High Scrutiny of Long-Term Disability Insurance Claims by Insurance Companies

{3:30 minutes to read} Filing a claim for long-term disability benefits is an exhausting and complicated process—especially in the early stages. Professionals need to be wary of what this process

Read More...

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The Chanin Building, 122 East 42nd Street, Suite 725, New York, New York 10168

Toll Free: (800) 745-1755
Phone: (212) 608-5445

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666 Old Country Road, Ninth Floor, Garden City, New York 11530

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Phone: (516) 745-1122
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