There are various types of disability insurance policies available. One of the most significant differences between them is whether the policy has an “own occupation provision” or an “any occupation provision.” Policies with an “own occupation provision” will pay 100 percent of the inability to perform the occupation for which the claimant is insured if the claimant is no longer able to perform that occupation—even if he or she goes back to work doing something else. A policy that pays only upon loss of ability to do any occupation, on the other hand, will decrease payments if the disabled person goes back to work at another occupation. Clearly, “own occupation” policies offer significant advantages over “any occupation” policies.
Unfortunately, the insurance industry does not regulate the various terms used in long-term disability policies. One carrier’s definition of an “own occupation” policy is not necessarily the same as that of another carrier. Insurance companies will sell policies as “own occupation” when they know full well that the policy is not a pure “own occupation” but rather a modified “own occupation” policy. The language insurance companies use is intentionally vague and confusing. Therefore, many policy owners who think they have purchased an “own occupation” policy do not in fact have one. On the other hand, consumers might not even know they have an “own occupation” policy, and the insurance company will attempt to lower their payments if they go back to work at another occupation.
In addition, many insurance companies attempt to persuade their “own occupation” policy insureds not to seek advice from an attorney in the hope they will accept a quick but inadequate settlement. The fact is, insurance companies will try just about anything to limit their liability and boost profits. This can include misleading interpretation of the confusing policy language, to practices that constitute outright bad faith. Such practices are by no means limited to small insurance companies. One of the largest disability insurance providers in the world has been condemned by 23 different state attorney generals for bad faith—and it is still in business, writing thousands of policies a year!
At Hensley│Chalfant, we have extensive experience defending our clients’ rights against insurance companies in cases involving “own occupation” disability insurance. Our unique combination of medical knowledge, experience with all forms of personal injury, and willingness to fight aggressively against insurance companies will give you the best chance of winning your case and getting all the benefits your expensive premiums have entitled you to. If you have purchased an “own occupation” disability policy, and the company that issued it is trying to lower your benefits or deny your claim, please contact us immediately for assistance.