Our Phoenix, Arizona based law firm represents professionals with own-occupation disability policies (principally physicians, dentists, attorneys and executives), and works with clients throughout the country. We provide free consultations, either by phone or in person, and welcome you to contact us with your questions.
Securing Your Disability Benefits
If you are a medical, legal or business professional facing a disability claim, the stakes are incredibly high. From the insurance company’s perspective, the moment you file your claim, you become a million-dollar-plus liability for them. And for you, it is not just about the money—your lifestyle, your home, your family and loved ones’ well-being are all on the line. You have one shot to make your case, and if you misstep and your claim is denied, challenging a denial typically requires years of costly and stressful litigation, all the while you are not earning an income and not receiving benefits.
Most of the time, a professional facing a potentially disabling condition first reaches out to the agent/financial advisor who sold them their policy. They are encouraged when their agent tells them they are going to get paid. They don’t consider that their agents, who are generally only trained to market and sell policies, do not have an understanding of the law or what the claims process may entail. Or that, no matter how well-meaning their agent is, their insurer is not going to pay the claim simply because the agent says it is good claim.
This misconception then lures them into a false sense of security, which results in a lack of preparation and a reliance on the insurance company (who has diametrically opposed financial interests) to tell them what to do. This, in turn, leaves them particularly vulnerable to bad faith tactics and/or making missteps that allow their insurer to deny or limit their benefits under provisions of their policies that they didn’t even know existed.
While those who are unfamiliar with the process may say that you do not need an attorney until your claim is denied, at that point it may be too late to remedy your mistakes or revive the claim. It is therefore critical that you learn how your policy and the claims process work before filing, so that you do not inadvertently prejudice your ability to collect under your policy.
While other disability lawyers are reactive to claim denials and insurers’ bad faith tactics, we prefer to be proactive. We prefer to work with our clients from the very outset, ideally before an insurance claim is even filed, so that we can be at their side to advise and represent our clients through the entire claim.
Protecting Your Disability Benefits
Many doctors (and lawyers) unfamiliar with professional disability insurance claims assume that the initial filing is “the claim” and an initial claim approval is “the win.” But obtaining a favorable claim decision is only the beginning.
Most “own occupation” disability policies pay monthly benefits, which means that your claim can (and is) constantly reassessed on a monthly basis for the lifetime of the claim. Most disability policies (particularly newer, post-2000 policies) also grant the companies broad investigative powers, including the right to require you to undergo medical exams at any time, appear for an in-person interview at any time, produce financial information (like your taxes) at any time, and the list goes on.
Oftentimes, companies will go away and leave you alone for a time, in the hopes that you become complacent. They may stop asking for reports and/or calling you as often, while continuing to gather medical records, talk to your doctors, and/or conduct surveillance (both online and in-person) behind the scenes.
If you have never been involved in a disability claim before and don’t have industry knowledge about how these companies operate, it can be very difficult to gauge whether your company is overstepping and/or targeting your claim for denial.
Because your insurer can revisit, challenge and deny your claim at any time, our attorneys continue to monitor our clients’ claims throughout the entire course of the claim. We require all requests for information to be handled through our office (including contact with treating doctors), so that we can evaluate whether the requests are appropriate and identify and address bad faith tactics before they result in a claim denial.
We also advise clients on how to handle the myriad of other obstacles that insureds must often overcome to receive disability benefits, including in-home interviews with claim agents; medical record reviews; psychiatric evaluations; Functional Capacity Exams; audits of individual and practice tax returns, insurance filings and billing records; demands for precise time quantification; and video and internet surveillance. Our disability insurance attorneys monitor the insurance company’s every step to protect against unreasonable delays, undue harassment, or misconstruing of information in processing clients’ claims for disability benefits.
Overturning Disability Claim Denials
Disability insurance claim denials can be extremely difficult to reverse. Insurance companies expertly document their reasons for denying disability benefits, and often do this behind the scenes, utilizing multiple in-house doctors, “independent” medical exams, and the like.
Many professionals facing a claim denial initially think that they can “work it out” with their analyst or that it was a “mistake” that can be easily corrected with a note from their doctor, or an updated test result. They forget that, when it comes down to it, their financial interests directly conflict with the insurance company’s financial interests, and this is especially true if your benefits have been denied or terminated.
We commonly consult with professionals who tried to handle a denial themselves (or who hired lawyers inexperienced in the industry) and ended up going through months and months of prolonged and unnecessary “reconsideration” and “appeals” before receiving yet another denial. Sometimes the company uses this time to shore up their positions, and then reveal that its in-house doctors have prepared multiple reports/opinions discounting your restrictions and limitations. They also use it as an opportunity to overwhelm your treating doctor with “follow-up” questions and test whether your doctor is going to stand by you or remove himself/herself from the process if it looks like things are headed to court. Another common tactic is to pass your claim from analyst to analyst, to supervisor, etc. until you just give up, or find yourself several months removed from the claim denial with no benefits coming in, and no progress being made.
These are not things that you want to be facing alone. Insurers have been denying professionals’ claims for decades now, and they are very adept at manufacturing bases for denials and stringing insureds along until they settle for much less than the claim is worth or abandon the claim entirely. If your claim is denied or terminated, you should contact an experienced disability attorney immediately.
Why We Win
Our professional clients hire our law firm because of the results we consistently deliver. We partner with our clients and any co-counsel as a unified team, with the goal of securing our clients’ disability insurance benefits rather than “managing” their expectations.
Developing a methodical plan is critical to our approach, especially for our clients who have conditions that are easier to undercut, and claims that are more likely to be denied or terminated.
Ranking Arizona has repeatedly recognized Comitz | Stanley as one of the state’s top boutique law firms, ranked #1 for our healthcare practice. Despite our firm’s small size, we outrank large regional, national and international law firms in healthcare, primarily due to our reputation for results in professional disability insurance claims and litigation.
Arizona Business Magazine lists Ed Comitz as one of the Top 5 Business Leaders in the field of Healthcare, and one of the Top 500 Business Leaders in Arizona overall. Referring to the honorees, Editor-In-Chief Michael Gossie commented: “The drivers of Arizona’s economy who are profiled … are leaders. They are innovators. They have influence. And when they speak, they make things happen.”
Accolades such as these, and the outcomes that drive them, are the result of our unprecedented industry experience, focus, talent and approach.
For almost 30 years, Ed has developed the only law practice in the country that focuses exclusively on professionals’ “own occupation” disability claims and litigation. As a result, Ed knows the disability insurers’ playbook, exactly how they operate, and how they approach high-dollar, “own occupation” claims (typically owned by physicians, dentists and attorneys).
Through years of hard-fought litigation, Ed has earned the respect of, and has developed relationships with, senior executives, disability claim department heads, in-house legal counsel and outside legal counsel at all of the major disability insurance carriers.
Claims involving our law firm are often “tagged” to warn the companies’ claims analysts to take care in conducting themselves.
Our professional disability law firm intensely focuses on only a select, small number of matters at a time, so that all members of our team have a command over the facts and legal issues at play.
Our attorneys personally vet each disability claim/case before accepting representation. We are selective in the matters that we take and all of the major disability insurers know that if we accept a matter, it is one that we personally believe in and will endlessly fight to protect.