Business owners, manager, and executives that find themselves unable to work are often faced with an exceptional burden of proving their disability. Unlike other professions, managerial positions require performance of a wide-range of duties as well as the responsibility to manage staff, interact with clients, and maintain production levels. When a disabling physical illness or injury makes it impossible to perform work in the normal manner, insurers may determine that the ability to perform some duties disqualifies the executive from Total Disability benefits.
This is not the case under California law. It is important for professionals in any industry to understand the details of their insurance coverage, ensure the coverage is for “own occupation,” and the duties of your job are accurately documented, including all of the duties performed and expected on a daily basis. Claimants should be prepared for a wide range of methods used by insurance companies to disprove their disability. Typical claim practices include investigations, Independent Medical Exams (IME), surveillance, and the questioning of associates and business partners. While you may be able to perform some of the clerical duties of your job, the definition of Total Disability per California law still applies: it is unlawful for the insurance company to engage in unreasonable delays, bad faith denials, deception or trickery during the handling of the claim.
In Long Term Disability cases, it is especially important to seek professional guidance before filing your claim. Quite often, treating doctors are unfamiliar with disability insurance, specific carriers, inclusions, exclusions, policy definitions and the claim process as a whole. We can help.
Assistance to Executives Filing Total Disability Claims
Ray Bourhis Associates recommends that business owners and executive policyholders throughout California:
- encourage their own medical professionals to adequately document their disabling conditions;
- perform all tests necessary to prove the conditions are affecting their ability to perform the specific duties required by the job;
- discuss the facts of the disability claim with the insurer completely and accurately; and
- to contact our firm with questions they have regarding the disability claim process.
California Long Term Disability insurance claimants may contact our lawyers at (415) 392-4660 for assistance.