By Lawrence Landskroner

Insurance companies can be sued for fraud, deceit, and conspiracy to defraud, if they deny or conspire to deny a disability claim.

If an insurance carrier unjustifiably refuse to provide a person with the benefits due him under his insurance police, it breaches the pact of good faith which according to law exists in every insurance policy. Actions such as this give a person the right to take a "bad faith' action against the insurance company.

In determining whether the insurance company breached its pact of good faith, one must ascertain if the insurance company took his rights into consideration to the same extent it took its own rights into consideration and it the insurance company willfully deprived him from enjoying benefits of his insurance policy.

While this bad faith conduct takes place in practically every type of insurance coverage, it take place most often in relation to workers injured on the job making claims under various types of disability insurance policies.

Some insurance companies have contrived a plan to turn down legitimate disability claims in a way to make disproval of the claims incapable of being disputed. They try to turn down the claims in such a way as to make the disproval seem justifiable.

Disability insurance carriers are put on alert as soon as they find out that a claimant's disability could be permanent or could exist for a long period of time. It is perverse that an insurance company would try to discontinue disability payments rather than encourage them. Most insurance adjusters have the idea that their primary responsibility is to terminate claims as soon as possible.

The development of bad faith law has prevented some insurance companies from turning down disability claims without a strong, justifiable reason. Unfortunately, however, these new laws have inspired the insurance companies to develop a more practical approach to accomplish their goals

If the insurance company can produce the guise of legitimacy in turning down a claim, it is less likely to be effectively disputed than those disproval which are obviously arbitrary.

An attorney concerned with protecting a disabled client from an insurance carrier which would deviously turn down his legitimate claim must disprove the apparently valid rejection of the claim and show that his client is the victim of an insurance company's scheme designed to make their denial of disability benefits appear justifiable.

Disability policies usually contain the stipulation that the insured be examined by physicians selected by the insurance company from time to time. This is a reasonable requirement, and cannot be disputed when used fairly. It is the misuse of this requirement, however, that enable unethical insurance companies to deprive their insured from legitimate disability benefits.

There is a select group of medical doctors who are used regularly by insurance companies to conduct these medical examinations. Certain physicians will conduct superficial and perfunctory examinations, and then report that the insured is not quite so disabled as to receive disability benefits. The use of these physicians usually takes place at the time a disability claim is first make or at a time when continued disability benefits depends upon the insured's capability of performing his regular duties or capability of performing any duties for which he is reasonably qualified.

Disability insurance policies usually provide benefits for approximately two years if the if the insured is disabled and unable to perform his normal duties. When the disability continues for longer than this period, the insured must be unable to perform any duties for which he is reasonably qualified.

It is common practice for a disability carrier to require that the insured be examined by a doctor from their select group of physicians regularly utilized for insurance company examinations to show that the insured may not be capable of performing his usual duties, but could very easily undertake an occupation for which he is reasonable qualified. At this time the potential for fraud and bad faith reaches its peak.