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

Fraud in the Insurance Claims Process by Evan Schwartz

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

Evan-Schwartz

Evan S. Schwartz
Founder of Schwartz, Conroy & Hack
800-745-1755
ESS@schwartzlawpc.com