Pennsylvania Disability Insurance Claims

We are a healthcare/professional disability insurance law firm with a national reputation for obtaining successful results for our clients. Our firm has represented physicians, dentists, lawyers, executives and other professionals throughout the country, with the goal of securing and protecting their entitlement to benefits on own-occupation disability insurance policies.

We consult with physicians, dentists, attorneys and business executives filing disability claims throughout Pennsylvania, including the Philadelphia and Pittsburgh areas. If you’d like to discuss your particular claim with our attorneys, we are happy to set up a free consultation.

Below are some resources for policyholders filing disability insurance claims in Pennsylvania. If you would like to learn more about the disability claim process or insurance bad faith in other states, please visit our homepage.

Does Pennsylvania Recognize Insurance Bad Faith?

Pennsylvania recognizes bad faith and the Pennsylvania Supreme Court has held that “[b]reach of . . . [the] obligation [to act in good faith] constitutes a breach of the insurance contract for which an action in assumpsit will lie.” Birth Ctr. v. St. Paul Companies, Inc., 567 Pa. 386, 400, 787 A.2d 376, 385 (2001) (internal citations omitted). Consequently, “where an insurer acts in bad faith, the insured is entitled to recover such damages sufficient to return it to the position it would have been in but for the breach.” Id.

Pennsylvania also has a statute that provides “[i]n an action arising under an insurance policy, if the court finds that the insurer has acted in bad faith toward the insured, the court may take all of the following actions: (1) Award interest on the amount of the claim from the date the claim was made by the insured in an amount equal to the prime rate of interest plus 3%. (2) Award punitive damages against the insurer; (3) Assess court costs and attorney fees against the insurer.” 42 Pa.C.S.A. § 8371.

The Pennsylvania Supreme Court has held that this statute “does not alter [an insured’s] common law contract rights” and does not preclude awards of known or foreseeable compensatory damages under the common law, because “[t]he statute does not reference the common law, does not explicitly reject it, and the application of the statute is not inconsistent with the common law.” Birth Ctr. v. St. Paul Companies, Inc., 567 Pa. 386, 402, 787 A.2d 376, 386 (2001).

The case excerpts above are not meant to be a comprehensive discussion of each state’s first-party bad faith or disability insurance law. They are merely meant to act as a resource/starting point for those interested in learning more about how insurance bad faith works in their state.

You should always speak with an attorney before making any legal arguments relating to your disability claim.

Notable Pennsylvania Disability Insurance Cases

Stein v. Paul Revere Life Ins., Co., No. CV 21-3546 (E.D. Pa. Mar. 16, 2023) (Pennsylvania radiologist filed a disability claim with Paul Revere/Unum due to spinal stenosis, spondylolisthesis, and osteoarthritis of the left thumb; Paul Revere classified his disability as due to “sickness” rather than “injury” in order to reduce the disability benefit payments owed under his policy; the radiologist argued that his claim was due to repetitive stress injuries to his back from wearing a heavy lead apron throughout his career; the court determined the disability was due to “injury”).

Falcon v. The Northwestern Mutual Life. Ins. Co., Civil Action No. 19-404 (W.D. Pa. Nov. 30, 2020) (Pennsylvania plastic surgeon filed a disability claim due to vision loss; Dr. Falcon believed he was eligible for lifetime benefits but Northwestern Mutual denied him lifetime benefits based on the age he became disabled; neither party could produce a copy of the policy and the case eventually settled).

Wagner v. Prudential Ins. Co., 14 Northumb. L. J. 386 (Pa. 1940) (Court found insured was not required to have an operation to secure disability benefits, because the operation was serious and attended with grave danger, and the cost of the operation would be almost equal to one year’s worth of disability benefits).

Common Disability Claim Questions

What should I expect when filing a disability claim?

What issues am I most likely to face handling my disability insurance claim alone?

Why are disability insurance claims made by physicians, dentists and other professionals especially targeted for denial or termination?

My disability claim was just denied. What should I do now?

What can my insurance company do when it is investigating my claim?

Do insurance companies conduct surveillance and, if so, when are they watching?

Why does my insurer want to conduct a field interview?

How can I tell if I have a true own-occupation policy?

What are the different types of disability policies?

Pennsylvania Federal District Court Locations

Professional disability claims are often filed in, or removed to, Federal Court given the amounts in controversy. When we work with local counsel to be admitted pro hac vice, we identify the courthouse that is closest to you. Below is a list of the primary Federal Courthouses in Pennsylvania, but there may be satellite courthouses that are closer to where you live.

Philadelphia. James A. Byrne U.S. Courthouse, 601 Market Street, Philadelphia, PA 19106.

Scranton. William J. Nealon Federal Building and U.S. Courthouse, 235 N. Washington Avenue, Scranton, PA 18503.

Pittsburgh. Joseph F. Weis, Jr. U.S. Courthouse, 700 Grant Street, Pittsburgh, PA 15219.

Who Do Your Disability Insurance Attorneys Represent?

The lists below provide a representative overview of the types of professionals we represent, the disability companies we file claims with and litigate against, and a non-exhaustive list of some of the disabling conditions our prior clients have had.

Professionals

Physician Claims & Resources | Dentist Claims & Resources

Disability Insurance Companies

Disabling Conditions

The information provided above is offered purely for informational purposes. It is not intended to create or promote an attorney-client relationship, and does not constitute and should not be relied upon as legal advice.

Every claim is unique and the discussion above is only a limited summary of information that may be relevant to your claim. An experienced disability insurance attorney can help you assess your particular disability claim, or potential disability claim, and determine what options are available to you.

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