Justin Frankel and Jason Newfield are both admitted to practice law in Pennsylvania’s Eastern District Courts. They are also able to represent disability insurance claimants in any state.
Pennsylvania is one of the original thirteen colonies, and is rich in American history. The sixth most populous state, Pennsylvania is a big state that borders six other states and includes a 50-mile slice of land along Lake Erie. Philadelphia is located at its southeastern tip and Pittsburgh is situated in the southwestern portion of the state.
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Frankel & Newfield has extensive experience in representing disability insurance claimants in Pennsylvania. We keep a close eye on developments in the Pennsylvania court system, and have reported on several decisions in our blog. In one particular case, a Federal Court in Pennsylvania found that CIGNA wrongfully terminated disability benefits for an insured because it wrongfully applied the "any occupation" definition. CIGNA argued that its decision was the result of a typographical error, which the Court completely rejected.
Any Occupation and Own Occupation, also known as "Any Occ/Own Occ" is a frequently occurring point of contention in long term disability insurance policies in Pennsylvania and other states. This is a provision that has changed over the last few decades. When long term disability insurance policies were sold in the 1970s and 1980s, most policies included Own Occ provisions that insured the policy owner’s ability to perform the tasks and duties of their own occupation. In other words, the company had insured your ability to do your specific job, whatever it might be. If you were a hand surgeon and could not longer operate, you were eligible to file a claim for benefits. You could embark on another career – even a high income earning career – and would still be able to collect benefits because you had been insured for the ability to be a hand surgeon.
An Any Occ disability insurance policy covers your ability to perform any kind of occupational tasks and duties. If you were a hand surgeon and could no longer perform the small and precise movements needed to be a hand surgeon, but you could use your hands in larger motions, like being an orthopedist or flipping burgers on a grill, you were deemed able to work.
Frankel & Newfield have represented individuals with both Any Occ and Own Occ policies, in ERISA administrative hearings, civil litigation and in Federal Courts. We understand that a hand surgeon is not about to take a job as a grill jockey and have successfully represented many clients facing an uphill battle when their policy is an Any Occupation policy.
The Any Occ/Own Occ issue is another example of the importance of having an actual copy of your disability insurance policy. Over time, the types of policies sold change and the provisions in the policies change. If you have an older policy, chances are you have an Own Occ policy and there are extra layers of protection built into the language of the policy.
If you have questions about Any Occ/Own Occ, call our office today.Ready To Talk?
Justin Frankel is a founding partner of the disability insurance law firm Frankel & Newfield and is a highly skilled litigator and advocate. He has published numerous articles on the challenges facing clients with private or individual disability insurance policies and those who own group or ERISA disability insurance policies.
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