New York 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 New York, including the New York City, Buffalo, and Rochester 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 New York. If you would like to learn more about the disability claim process or insurance bad faith in other states, please visit our homepage.
Does New York Recognize Insurance Bad Faith?
New York recognizes a duty of good faith in insurance contracts. As explained by the New York Court of Appeals, “[t]he implied covenant of good faith and fair dealing ‘embraces a pledge that neither party shall do anything which will have the effect of destroying or injuring the right of the other party to receive the fruits of the contract.’” ABN AMRO Bank, N.V. v. MBIA Inc., 17 N.Y.3d 208, 228, 952 N.E.2d 463, 475 (2011).
Additionally, the New York Court of Appeals has set forth several rules relating to damage awards in insurance cases. For example, the New York Court of Appeals has held that “consequential damages resulting from a breach of the covenant of good faith and fair dealing may be asserted in an insurance contract context, so long as the damages were ‘within the contemplation of the parties as the probable result of a breach at the time of or prior to contracting.’” Panasia Ests., Inc. v. Hudson Ins. Co., 10 N.Y.3d 200, 203, 886 N.E.2d 135, 137 (2008).
As another example, the New York Court of Appeals has determined that the standard for awarding punitive damages in insurance cases is a “strict one” that is available “only in a limited number of instances.” Rocanova v. Equitable Life Assur. Soc. of U.S., 83 N.Y.2d 603, 613, 634 N.E.2d 940, 943-44 (1994). More specifically, “a private party seeking to recover punitive damages must not only demonstrate egregious tortious conduct by which he or she was aggrieved, but also that such conduct was part of a pattern of similar conduct directed at the public generally.” Id.
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 New York Disability Insurance Cases
Doe v. Unum Life Ins. Co. of America, No. 12-CV-9327 LAK (S.D.N.Y. July 9, 2015) (New York trial attorney diagnosed with anxiety, major depression, OCD, ADHD, obsessive compulsive personality disorder and Asperger’s syndrome filed for disability; the court found that Unum’s file reviewers’ opinions were not credible or reliable, and it rejected the argument that Doe’s psychiatrist should have provided more than a treatment summary in support of the claim).
White v. Continental Casualty Co., 831 N.Y.S.2d 631 (2007) (New York physician specializing in orthopedic spinal surgery filed a claim for “total disability benefits”; after his date of disability, Dr. White maintained a medical practice in which he rendered second opinions with regard to surgery, performed independent medical examinations, and provided expert medical testimony, all in connection with spinal injuries; the court determined that Dr. White was unable to perform his former occupation as surgeon but was not “totally disabled” under the terms of his specific policy because he was still engaged in a “gainful occupation”).
Acquista v. New York Life Ins. Co., 285 A.D.2d 73, 75-77 (N.Y. App. Div. 2001) (New York physician with specialties in internal and pulmonary medicine became ill with a disease that could escalate into leukemia; Dr. Acquista could no longer be exposed to any radiation and the court determined that he had raised triable issue of fact as to whether this limitation made it impossible for him to perform “‘the substantial and material duties’ of his regular job or jobs as they existed prior to the onset of his illness”).
Shapiro v. Berkshire Life Insurance Company, 212 F.3d 121 (2nd Cir. 2000) (New York dentist with progressive osteoarthritis and spondylosis of the elbow, neck and other joints filed a disability claim with Berkshire/Guardian; Dr. Shapiro performed chairside dentistry but was also a business owner and Berkshire attempted to make a “dual occupation” defense; the court found that Dr. Shapiro’s administrative work was merely incidental to his material and substantial duties as a full-time dentist).
Goldberger v. Paul Revere Life Ins. Co., 165 F.3d 180 (2d Cir. 1999) (New York surgeon diagnosed with atrial fibrillation filed a disability claim under a specialty-specific policy; the court ruled against Unum and found that physician’s inability to engage in medical specialty constitutes a total disability despite the physician’s ability to engage in other medical practice activities).
Dawes v. First Unum Life Ins. Co., 851 F.Supp. 118 (S.D.N.Y. 1994) (New York Senior Vice President of a government bond and securities trading firm became disabled due to alcoholism; the court found that “the applicable definition of ‘regular occupation’ shall be a position of the same general character as the insured’s previous job, requiring similar skills and training, and involving comparable duties”).
Dixon v. Pacific Mutual Life Ins. Co., 268 F.2d 812 (2d Cir. 1959), cert. denied, 361 U.S. 948, 80 S.Ct. 406, 4, L.Ed.2d 381 (1960) (Physician purchased an occupational disability policy that described his occupation as that of a physician and surgeon, and became disabled due to dermatitis of the hands; for many years prior to the onset of his disability, Dr. Dixon had exclusively engaged in practicing surgery and the court found he was totally disabled under the meaning of the policy, though he retained a residual capacity to practice as a physician).
Common Disability Claim Questions
New York 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 New York, but there may be satellite courthouses that are closer to where you live.
New York. Daniel Patrick Moynihan U.S. Courthouse, 500 Pearl Street, New York, NY 10007; Thurgood Marshall United States Courthouse, 40 Foley Square, New York, NY 10007.
Brooklyn. 225 Cadman Plaza East, Brooklyn, NY 11201.
Albany. James T. Foley U.S. Courthouse, 445 Broadway, Suite 509, Albany, NY 12207.
Syracuse. James M. Hanley Federal Building and U.S. Courthouse, 100 S. Clinton Street, Syracuse, NY 13261.
Buffalo. 2 Niagara Square, Buffalo, NY 14202.
Rochester. 2120 Kenneth B. Keating Federal Building, 100 State Street, Rochester, NY 14614.
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.
Anesthesiologists | Attorneys | Cardiologists | Chief Medical Directors | Chiropractors | Commercial Real Estate Brokers | Corporate Executives | Emergency Medicine | Endodontists | Gastroenterologists | General Dentists | Gynecologists | Internal Medicine | Neurologists | Neurosurgeons | Obstetricians | Ophthalmologists | Oral Surgeons | Orthodontists | Orthopedic Surgeons | Otolaryngologists | Physical Therapists | Podiatrists | Professional Athletes | Prosthodontists | Psychiatrists | Psychologists | Pulmonologists | Radiation Oncologists | Radiologists | Rheumatologists | Veterinarians
Disability Insurance Companies
Aetna | AIG | Allstate | Anthem | American General | Ameritas | Berkshire Insurance Group | Boston Mutual | Cigna/LINA | Colonial Life | Connecticut General | Davies Life & Health/Disability Management Services, Inc. | Disability Reinsurance Management | First Unum | Fortis | Great West | Guardian Life | Hartford | Jefferson | John Hancock | Liberty Mutual | Lloyd’s of London | Mass Casualty | Mass Mutual | MetLife | Monarch | Mutual of Omaha | National Life of Vermont | New York Life | New England Life | Northwestern Mutual Life | Ohio National | Paul Revere | Penn Mutual | Phoenix Life Insurance | Principal Life | Provident | Prudential | Reassurance America | Reliance | Reliance Standard | Sedgwick | Standard | Sun Life | The Equitable Life | Transamerica | Trustmark | Trustmark Disability Advisors | Union Central | Unum | UnumProvident
Aneurysms | Anxiety/Panic Attacks | Angina Pectoris/Ischemia | Arthritis (Osteo, Psoriatic, Rheumatoid) | Atrial Fibrillation (AF) | Autoimmune Disorders | Bipolar Disorder | Brachial Plexus Injuries | Bulging Discs (Cervical/Lumbar) | Bursitis | Cancer | Carpal Tunnel Syndrome (CTS) | Cervical/Neck Pain | Crohn’s Disease/IBD | Complex Regional Pain Syndrome | Congestive Heart Failure | Coronary Artery Disease | Deep Vein Thrombosis (DVT) | Degenerative Disc Disease (DDD) | Dislocated Elbow/Shoulder | Dislocated Hip/Hip Replacement | Epstein-Barr Virus (EBV) | Essential Tremors | Focal Dystonia | Ganglion Cysts | Glaucoma | Hand/Arm Pain – NOS | Head Trauma/Cognitive Difficulties | Hearing Loss | Herniated Discs (Cervical/Lumbar) | Ligament Tears | Long-Haul COVID | Lumbar/Back Pain | Lyme Disease | Major Depressive Disorder (MDD) | Macular Degeneration | Meniere’s Disease | Migraines | Multiple Sclerosis (MS) | Musculoskeletal Disorders | Myasthenia Gravis (MG) | Myelopathy (Cervical/Lumbar) | Myofascial Pain Syndrome | Nerve Impingement/Entrapment | Neuroma | Orthostatic Hypertension/Hypotension | Osteoarthritis | Paresthesia/Dysesthesia | Parkinson’s Disease | Posterior Tibial Tendon Dysfunction | Post-Traumatic Stress Disorder (PTSD) | Posterior Tibial Tendon Dysfunction | Posterior Vitreous Detachment (PVD) | Radiculopathy (Cervical/Lumbar) | Repetitive Stress Injuries | Retinal Detachment/Floaters | Rotator Cuff Injury/Tears | Sciatica | Scoliosis | Serotonin Syndrome | Shoulder/Back/Neck Pain – NOS | Sleep Apnea | Spondylolisthesis | Spondylosis | Stenosis (Spinal/Foraminal) | Stroke | Thoracic Outlet Syndrome (TOS) | Traumatic Injuries | Tumors | Ulnar Neuropathy | Vertigo/BPPV | Visual Impairment
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.