Frequently Asked Questions Regarding Long Term Disability Litigation

At Adelman German, our attorneys are determined to help clients assert valid disability claims, despite highly objectionable tactics by the insurance company. We have recovered tens of millions of dollars over the years for clients who were wrongfully denied benefits.

It is natural that you have many questions. We encourage you to read through this FAQ page and give us a call today to arrange a confidential, no-cost consultation about your case. Based in Phoenix, we serve clients across Arizona.

Q: Do Some People Give Up On Making A Disability Claim?

A: Yes. Sadly, insureds walk away from their legitimate disability claims all the time, especially those suffering mental illness. These particular clients are often the most vulnerable, and most likely to abandon their claims. We are especially passionate when it comes to these claims and work hard to ensure our clients' trust. We let our clients know every step of the way that we are on their side, and sensitive, compassionate, nonjudgmental and understanding.

Typically, people who come to see us are at the lowest point in their life. Fighting with insurance companies to obtain what is owed is not only demoralizing but it can be destructive to the individual and to his or her family. We understand how important your disability claim is, and will do everything we reasonably can to ensure you are treated fairly and with dignity, and to ensure you are paid disability benefits owed. Do not wait and allow an insurance company to intimidate you or to take advantage of your situation. Call Adelman German at 480-478-1185.

Q: What Duties Does Your Insurance Company Have?

A: All insurance companies owe a duty to act in good faith and to deal fairly with insureds.

Your insurance company must promptly, thoroughly and fairly adjust your claim. It owes you a duty to pay valid claims timely. An insurance company that fails to fairly evaluate and pay your claim can become liable for its bad faith conduct. It is bad faith for an insurance company to only consider facts supporting a denial while ignoring those facts that support paying your claim. This is called "cherry-picking."

Q: What Can A Lawsuit Accomplish?

A: Adelman German represents clients who have been forced to file a lawsuit against their disability insurance company. In those instances, suit is brought to collect disability benefits owed. In addition, in Arizona, an insured can sue the insurance company for extra-contractual damages for things such as pain, suffering, annoyance, damage to credit and other damages suffered because an insurance company put its own interests ahead of its insureds. Additionally, an insured may be entitled to punitive or exemplary damages to punish the insurance company and to deter others from acting the same. Finally, the court can order that the insurance company pay your attorneys' fees.

If your insurance company is acting unreasonably by dragging its feet, refusing to pay benefits you are owed, or refuses to fairly consider your interests, at Adelman German, we understand the hardship and damages you may be suffering. You may be unable to pay your mortgage, medications or otherwise be looking at financial devastation. When you hire our law firm, we will fight for justice on your behalf.

Do not allow an insurance company to make you feel as though you are at their mercy. You have rights, and you should not be forced to take on your insurance company by yourself.

If an insurance company is treating you unfairly, please contact us today online or by telephone at 480-478-1185 to speak with an experienced Arizona lawyer.

Q: What Are The Basics Of A Disability Insurance Claim?

A: At Adelman German, we represent disabled medical professionals and business owners and help them recover disability insurance benefits owed under policies purchased when they were oftentimes younger and healthier. Your policy will likely include "own occ" [Own Occupation] language, and will provide benefits if you are only able to partially return to work. It is important you understand certain terminology in the disability insurance context, and understand differences between policies purchased from an agent versus policies obtained as part of a group-benefit plan.

Our clients typically own policies purchased from agents or directly from the insurance company, which are distinguishable from ones secured through group-benefit packages offered by an employer. Our firm does not handle claims stemming from group-benefit plans. Those claims are unique and are typically governed by ERISA laws and not Arizona's insurance bad faith laws. Our law firm's focus is in on disability insurance bad faith claims stemming from an insurance company's wrongful refusal to honor or pay valid disability insurance claims.

Q: What Benefits Are Allowed By Your Policy?

A: The disability insurance policy is the road-map to your claim. It will tell you benefits owed, maximum benefit periods, how and when to file a claim and more. You should familiarize yourself with terms that have special meaning in the disability insurance context in order to better understand the benefits you may be owed.

Q: What Is "Own Occ" Total Disability?

A: A monthly benefit may be owed under your policy if you are unable to perform the substantial and material duties of your regular occupation, i.e., your own occ. This benefit is payable even if you are able to work in the same field or industry. For example, a neurosurgeon with a tremor may qualify for "total disability benefits" if he is unable to handle brain surgery, even if he continues with an office-based medical practice.

Q: What Is Residual (or Partial) Disability?

A: A portion of your monthly benefit and sometimes the entire monthly benefit may be owed if you are unable to perform some of the material duties of your occupation or if you are able to perform all of them but at a reduced level. For example, if you suffer back problems that prevent you from working more than a few hours per day, you may be entitled to a residual (partial) disability benefit.

Q: What Is Presumptive Disability?

A: If you lose your sight, hearing, the ability to speak or the use of any two limbs, you may be entitled to disability benefits whether or not you are able to continue to work in your own occupation or any other.

Q: What Is The Waiting Period?

A: The "waiting period" is the period of time before benefits are payable. Typically, policies require a 90-day waiting period for individual disability income benefits, and a 30-day waiting period for Business Overhead Expense (BOE) claims.

Q: What Is A Business Overhead Expense (BOE) Policy?

A: A Business Overhead Expense policy is in place to cover expenses incurred by the insured while he or she is disabled. It helps to defray overhead your business incurs while you are disabled. This coverage is often used to pay fixed expenses including leases, electric, water, wages or other commitments during a period of total or residual disability.

Q: What Is Waiver Of Premiums?

A: A common feature of disability insurance policies is waiver of premiums. This means that the policy remains in force and active while you are disabled, and you do not have to pay premiums over that time.

Q: What Are Riders?

A: A Rider is included as a part of an overall insurance policy, but is usually found at the end of the policy and contains its own, particular terms. A Rider can provide for "lifetime benefits," or "COLA" (cost-of-living) benefits, or it can define "Own Occupation" in a way that favors the insured. It is therefore very important that you consider the entire policy, including the attachments, and not just the main body of the policy.

Q: What Are ERISA Claims?

A: Long-term disability (LTD) clams differ from Individual Disability Income (IDI) claims, and are governed by much different laws. Adelman German handles IDI claims, but does not typically handle ERISA claims. Most disability insurance through an employer is governed by the Employee Retirement Income Security Act (ERISA), which regulates a vast number of employee benefit claims, including long-term disability insurance claims.

Q: Is There A Specific Arizona Law On Unfair Insurance Practices?

A: Arizona's Unfair Claims Settlement Practices Act (the "Act"): Arizona stands tough against insurance companies that treat their insureds badly. There are specific statutory and regulatory guidelines in Arizona governing particular conduct of insurance companies. An insurance company that misrepresents policy provisions, fails to acknowledge pertinent communications, fails to reasonably or fairly investigate a claim, and/or fails to promptly, fairly and equitably adjust a claim, may be in violation of this Act.

Q: What Is A Lump-Sum Settlement In Exchange For Surrender?

A: Once your claim is approved and you are receiving benefits for a length of time, your insurance company may offer to pay you a lump sum of money in exchange for the surrender of your policy. The amount paid is dependent on the amount of your monthly benefit, the maximum benefit period, your disabling condition and the likelihood your disability will continue indefinitely. The amount paid is also dependent on present-day value calculations. We would encourage you to seek legal advice from an experienced attorney before you accept a lump-sum settlement in exchange for the surrender of your policy.

Do Not Navigate A Disability Claim Alone

Our lawyers at Adelman German have extensive experience combating insurance tactics and winning cases for our clients. We carefully examine every case, and learn as much as we can about your profession, your needs and your expectations so we can better represent you. We do not believe in a cookie-cutter approach, and we understand that your claim is unique.

If you are faced with making a disability claim due to an illness, or if you have suffered an abrupt injury and are unable to work in your occupation or otherwise, please give us a call at 480-478-1185, or complete our online form.

Whether your benefits were denied, or you are preparing your initial paperwork, we can help with every aspect of your claim so you can concentrate on putting the other pieces of your life in order. We accept clients throughout Arizona and the United States.