Disability Insurance Blog



Monday, August 30th, 2010

Just in case you ever question whether or not your decision to fight back when the long term disability insurance claims adjuster terminates or denies your claim, last week’s decision by the United States Court of Appeals for the Third Circuit will easily rest any concerns you may have about whether or not it’s worth pursuing.

The Court document starts with the allegations of “massive conspiracies throughout the insurance industry” made by purchasers of commercial and employee benefit insurance. These purchasers allege that the insurance companies entered into deceptive schemes with brokers to allocate their purchases among insurance companies. In other words, rather than compete against each other for business, the insurance companies and the brokers were making decisions about which company would sell to which purchaser.

It was alleged that the conspiring brokers directed the purchasers to the desired insurance companies and accepted contingency commission payments that were built into the fees being paid for the insurance premiums.

The heart of the decision is a somewhat technical matter – The Court of Appeals determined that the District Court’s decision to dismiss the charges was wrong, that the case needs to be reopened and charges need to be considered under the anti-trust and anti-racketeering laws.

But the fundamental issue – of trust – is the same that underlies all of the cases that we work on. You pay the premiums on these insurance policies, trusting that if you should ever need to file a claim, the insurance company will pay the benefits as described in your contract.

If you find yourself in a situation where the insurance company claims that you have no claim, call our office to learn how we can help.