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Law Educator, Esq.
Law Educator, Esq., Attorney
Category: Business Law
Satisfied Customers: 118087
Experience:  All corporate law, including non-profits and charitable fraternal organizations.
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the fact is that following this event I purchase a disability

Customer Question

the fact is that following this event I purchase a disability policy both for bisuness and on my person that pays office expenses for 2 years and me incase of illness or accident. the policies were purchased after extensive examination and questions, and the day it was delivered was the day the seconed attorney was in my office for the first time to collect the 10000 and evidense. so he asked me what these policies are? I replied insurance for disability. he asked me to reveiw them and I said suure. he found question 14 had asked if there is a complain pending against me and I had answered no, he said unless I changed that to yes If I become disable , they will not pau for disability and return my money. so we asked the agent to speak with underwriting and tell them we want the answere changed as there is at least one complain pending againstme( THE OTHR EMPLOYEE HAD ALREAY ADMITED SHE LIED THAT SHE DIRECTLYHAD NEVER SEEN UNLICENSED ACTIVITY AND IT WAS HERESAY when she had been questioned further by the investigator.
The agent send me and my attorney and email indicating that he hd spoken with MR. WW and informed him that there is a complaint PENDING and if it was going to affect their decision or fee. Mr. ww said he will make a note in the chart that we want to change the answere to yes, however it makes no diferrence in any of the provisions of the policy and the policy remains in full effect after 2 years the stress of this lawsuite with added several others and employees and dr.'s leaving , I started to suffer from insomnia and severe pain in my back neck and hands. Visited with a neurologist very stressed and after exam she said possible herniated disx and carpel tunnels as well as depression were the cause but we need nerv conduction and MRI study in may 2010 the result came back that there were herniation of discs in my neck suppluing innervation to my hands. and spinal stenosis(narrowing of spinal canal) and that I shoud avoid practicing dentistry , that it will excescebare my condition. As I let Agent know , after evaluating the documents 1000s of pages, in december 7 months later , they send a letter that I misrepresented and lied on the application first by sayng no, and then by further lying I chande my answere as ther was a complain against me but it was RESOLVED and had they known there was a complaint against me , they would have never written the policy( 2ed missatatement of facts) after 3 months of searching for an appropriate attorney as the one helping me with DOH said he is my witness and can not defend me nor could he refer me to anybody. I found another lawyer in alabama, and he could not beleve how stupit they were turning a 600k case into a multi milion dollar case. asked for retainer od 7500 or 35% of money owed to date which was already 375k and I did not have a lot of funds lsft having paid for practice expenses and agreed with 35%. in one week they admited to their mistake and reinstated the policy however they were paying based on partial disability half of what they were suppose to pay.
so we thretened them again to take them to court on bad faith as she had purposely changed the word peding for resolved, it was not like she had missed the note and saw the underwiter remark that this answere does not make any changes to this policy.In the mean time I am losing 15000 per month because of attorney fees and when they admited to theur mistake they still did not want to pay and wanted to investigate more. as my alabama attorney had said in his research that florida law states an insurance company has to accept or deny a claim within 90 days . after 120 days they have to pay for the claim irrifutebly? and They are still not paying for full disability, and attorney fees that they cost us and I am losing money everymonth. My attrney says let's collect while they are paying and then sue them because if we sue them now they will stop paying. that is good for him but not fr me as he makes a 8000 per month and I lose 13000 per month. however 6000 is paid on personal side as well which cuts my losses and the atorney deos not charge me 35%on that since 2 months ago but did for a year.Now you have the final question
what should we do ? as the attorney for DOH says we should accept the offer or they willl harrace and would want to do more investigation and if they find something wrond is troub;e. The disability copmpany is my biggest problem as I have lost 400k and they are not paying full benefit and claim I can do a few hous of work.
Submitted: 5 years ago.
Category: Business Law
Expert:  Law Educator, Esq. replied 5 years ago.
As far as the insurance policy issue, your attorney on that case has seen all of the evidence and if his recommendation is to settle, I could not tell you he is wrong. He is intimately familiar with the facts and evidence and has had a chance to evaluate that evidence and I will have to defer to his judgment here.

As far as DOH, sure they want you to accept their offer because they do not want to lose the suit you have against them and they are afraid to lose it or they would not be putting so much pressure on you. At this point, I would document their threat to harass you and every time they do I would sue them again and I would continue pursing your case against the negligent agents.

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