The information you put on your long-term disability claim forms and monthly progress reports are all material representations by you to your insurance company—and must be factual!
A recent case involving a man who has been alleged by the New York State Attorney General of fraudulently obtaining $1.3 million in disability benefits from his insurance company is a dramatic example of why not to mislead or misrepresent that information.
In this case, the individual is alleged to have falsely submitted statements to his insurance company—claiming a non-working status on his form. In fact, not only had he continued to practice medicine, he did so without a license (which was apparently lost in 2007).
The man was indicted for practicing without a license and, primarily, for misrepresenting his work status and collecting $1.3 million dollars from his long-term disability insurance company for a period of four years.
Our firm represents over 300 clients in varying stages of the claims process—most of whom are getting paid. Periodically, progress reports must be submitted to the insurance company which includes information about:
•What the person is doing;
•Whether he or she is working;
•Activities he or she participates in, and more.
Often, people will just duplicate the content of the forms over a span of years; yet, in fact, activity levels, etc. may have changed. Accuracy is essential; your receipt of insurance benefits could be jeopardized due to misrepresentation on a claim form.
A sophisticated long-term disability lawyer can ensure that your forms are not misrepresenting your status, nor willfully withholding information that should be disclosed. This particular case is a cautionary tale: people must be careful and truthful with the information shared on their insurance claim forms.
Please contact us with any questions or comments.
Evan S. Schwartz
Founder of Schwartz Law
We as a society are not prepared to deal with catastrophic illness, and although I was smart enough to have taken out a Long-term Disability policy in my thirties, the
Desperate and devastated with everything to lose, I put my life in the hands of Evan and Michail on faith. In my heart I always believed they would deliver, and
During the most trying part of my life, Schwartz Law’s attorneys were fighting for my life. I was physically just barely up on my own two feet, with a diagnosis
A company made an error in how they sold me my long-term disability insurance policy and they offered me a lump sum settlement. I did not fully understand the offer
My claim was denied by my insurance company. My medical condition wasn’t understood by my physicians. My first attorney gave me terrible advice. My family faced financial ruin without the
The Chanin Building, 122 East 42nd Street, Suite 725, New York, New York 10168
Toll Free: (800) 745-1755
Phone: (212) 608-5445
666 Old Country Road, Ninth Floor, Garden City, New York 11530
Toll Free: (800) 745-1755
Phone: (516) 745-1122
Fax: (516) 745-0844