Insurance Bad Faith – in Denial of Disability Insurance

When a person purchases insurance, they assume that they will be protected by the insurance company against the loss for which their purchasing insurance for – either from injury or from some major or catastrophic event.

Unfortunately, it is our experience that this is not always true. Insurance companies sometimes look for ways to deny claims even if they do not have a valid or justifiable excuse for the denial of the claim. They do this because they know that many insured will do nothing and accept the insurance company’s denial of their claim. Even if they know their denial is wrong. When this occurs, it is called “bad faith”.

When you purchase insurance from your insurance company, the law recognizes that you place your trust, confidence and faith in them. This breach of that trust and confidence and the betrayal of the denial of your claim is the bad faith which is the basis of bringing a claim against the insurance company for its wrongful failure to pay you the benefits of your insurance policy. Examples of bad faith can involve a disability insurance company failing to investigate a claim, the delaying of the claims investigation for no apparent reason, the failure to provide payment on a claim which is covered, or the misrepresenting of the contract language in the insurance policy. Unfortunately, all of these items often occurs.

Consumers and professionals who have been unfairly denied long-term disability benefits may be entitled to compensation. Nadrich & Cohen are experts in insurance bad faith and in obtaining disability benefits for those who have been denied.

If your insurer has denied your disability benefits, please immediately contact us at the national Law firm of Nadrich and Cohen to learn your legal rights. Contact us at 1-800-218-4658 or by completing the email questionnaire by clicking here.

We are insurance experts. Our law firm and our affiliated law firms have obtained hundreds of millions of dollars in recovery on insurance denial lawsuits.

Please immediately contact our Insurance Denial Hotline at (800) 718-4658 or email us.

Underwriting Basics

What is underwriting? You have heard this term from time to time when dealing with insurance or maybe even when applying for a mortgage. But what is it? In terms of insurance it is simply the name for the process of deciding what risk an insurance company is willing to take on. What is risk, you are wondering? It is the chance of a loss occurring as a result of an unfortunate consequence.

There are many factors that an underwriter weighs when considering an application for insurance. Ultimately, the insurance company will decide on an applicant’s insurability. Each individual case, or application, is put through a process and a final decision on what the insurance company is wiling to do is made. Always keep in mind that if you are working with an insurance agent that person may never guarantee a policy’s issuance or how it will be issued.

The items that an underwriter will use to consider your application are the application forms themselves, a physical exam, information obtained by various consumer reports, an attending physician’s statement, and an inspection report. Different cases require different underwriting requirements, so not all cases require any or all of these items listed here. However, when the case applies, and depending on the amount of insurance applied for, usually higher amounts, the insurance company may want to have an inspection report be done to verify things like, verifying a person’s character and reputation.

The underwriter will eventually be able to match the proposed insured to a risk classification. This is a grouping of people of similar insurability. You may have heard of the common names of these groups such as, Standard, Preferred, Non-Smoker and Smoker, to name a few. Someone who has been deemed a substandard risk may still be able to obtain insurance coverage. They will get it based on being a higher risk. The health implications of someone who is a smoker will allow for the company to apply a higher rate and therefore, charge a higher premium for taking on their risk.

There are different ways that companies figure out the extra amount due for a substandard risk. One example is the insurance company may apply charges based on something called the “health age” of an applicant. But, a more common way of assessing a higher rate, and therefore premium, is the Tabular Rating Method. With this way, tables are created and utilized by the insurance company to apply the proper percentage more of premium that would be due. This can range from approximately 25% higher to maybe 400% higher, which would be indicated by referencing a respective table assigned by the company.

When thinking about getting a life insurance policy in place to protect your family in a time of need, there are many aspects of obtaining insurance that can be educational. With the common practice of using the internet there are very easy ways today to log on to a website and get connected with an insurance agent …

Personal Alarms, A Must For All Women

Ladies, here are some unfortunate statistics that are undoubtedly disturbing: One in three of you, (American women) will be sexually assaulted in her lifetime and one in four female college students have either been raped or have suffered from attempted rape! This is truly unacceptable in today’s society, but in reality it’s an ongoing trend that never seems to subside in spite of our continued education and ever expanding punitive laws.

I hope that you are like me, a realist, in the fact that we should be proactive in trying to protect ourselves by any means possible if necessary. I’m aware that many of you ladies are hesitant to even consider carrying a weapon for various reasons, this is understandable, that is why I would like to discuss a second option that can be very effective in itself in warding off an attacker, this is the “PERSONAL ALARM.”

PERSONAL ALARMS are small electronic devices that are carried on your person at all times and are activated by you if you are accosted in some way. These alarms emit some big noise, generally they are in the range of 100 to 130 decibels each, the noise being adequate enough to be heard a good 1/4 mile away.

So why are they so effective? Just think to yourself….does an attacker want to stick around a crime scene if there is a blaring signal that calls attention to your plight? An effective PERSONAL ALARM is a call to action, it is a distress call that will either bring help or curious onlookers and that would more than likely be enough to convince a would be attacker to flee the scene. I would even suggest it as a deterrent device, if you think that a person is getting too close to you and you sense a potential problem, just activate your alarm!

The Police have also long espoused the use of PERSONAL ALARMS for women because they are a non-lethal and effective form of self protection. Women who attend college, in lite of the alarming statistics mentioned earlier, should all carry a personal alarm. As a parent, you might want to insist on this. The sad truth is that many rapes on campus occur in a room that is surrounded by other rooms that are occupied at the time, if an alarm were to sound, more than likely many of these rapes could be thwarted.

PERSONAL ALARMS are varied, some can be carried on a key chain for easy access or clipped on a belt or purse. Some alarms also have an added feature of a flashlight or LED light, these are great for real estate agents that work at night or night shift employees. Probably the best type of alarm, in my estimation, is the kind that comes with an activation pull out pin. This type of alarm is activated by pulling out a wrist strapped pin from the unit, this is a great feature because an attacker will not be able to …

Managing the Non-Employee – Freelance Workforce

Managing the Non-Employee – Free Lance Workforce

Schwartz Heslin Group, Inc.

by Frederic J. Buse, Managing Director

Beginning in 1985, the New York State Dept. of Labor began issuing occupation- specific guidelines to clarify who should be classified an employee and who is an independent contractor.

From 1985 to 2005, guidelines covering 10 industries were issued but and none since.

 

Chart 1
Existing NYS Dept. of Labor Guidelines Cover the Following 10 Occupations:

Form Number:   Description

IA318.11:           Agricultural Employment

IA318.16:           Organized Camps

IA318.17:           Performing Artists

IA318.18:           Insurance Sales Industry

IA318.19:           Newspaper and Shopping Guide Publishers

IA318.20:           Translating and Interpreting Industry

IA318.21:           Tour Guide Industry

IA318.22:           Van Operators In The Moving Industry

IA318.23:           Magazine Publishing Industry

IA318.24:           Messenger Courier Industry

Source: (See http://www.labor.state.ny.us/formsdocs/ui/formsandpublications.shtm ).

By  contrast,  California’s  Employment  Development  Department  has  issued  “Information   Sheets”  covering  22  occupations  or  industry  segments.  
(See http://www.edd.ca.gov/Payroll_Taxes/Forms_and_Publications.htm)

It is difficult to determine what constitutes employment to establish employer liability for UI taxes and claimant coverage for unemployment insurance purposes. With the exception   of   certain   specific   exclusions   and   inclusions,   the   term   “employee”   is   not   defined and there is no statutory basis for distinguishing between and employee and an independent contractor.

In most instances, this issue is raised when a worker applies for unemployment benefits. The last employer is contacted by the Dept. of Labor and asked for the circumstances of job loss. If the employer indicates that the worker was an independent contractor and not an employee, information regarding the facts and circumstances of the  claimant’s  work  status  will  be  requested  by  the  Liability  &  Determination  Section  of   the   Dept.   of   Labor   (“L&D”)   — typically from both the claimant and the employer. After completing its fact finding, L&D will issue a determination letter. If they find that the claimant was an employee, the Labor Dept. will notify the office which processed the claim that the claimant is eligible for UI benefits. L&D also will send a determination letter to the employer citing the factors which led to the decision regarding employment, instructing the employer to file amended UI tax returns to include the taxable wages of the claimant and all other similarly situated individuals. The employer has 30 days to appeal the decision to an Administrative Law Judge. The next level of appeal is the UI Appeal Board.

If the employer fails to respond with revised tax returns and does not appeal the decision, he should expect a visit from a Dept. of Labor auditor. The auditor will review payroll information concerning the applicant for unemployment insurance and all other workers with similar work responsibilities. Approximately 10,000 such audits are completed annually. As a result of such an audit, requests/demands for additional UI tax payments plus penalties of $50,000 or more are not unusual.

The NYS Dept. of Labor adjudicates many more employee vs. independent contractor cases than any other state agency. It is increasingly clear that it has targeted considerable audit resources to indentify employers who misclassify employees as independent contractors. At the request of the …