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July 2015 Archives

Is an Emergency Room Physician Working as a General Practice Physician Totally or Partially Disabled under a Disability Insurance Policy?

Whether an emergency room physician working as a general practice physician is totally disabled or partially/residually disabled under a disability insurance policy depends on the type of disability insurance policy that is at issue, and the law governing the policy and claim filed. However, under many "own occupation" disability insurance policies, an individual whose occupation at the time of "disability" was truly emergency room doctor should be considered "totally disabled" if he or she is unable to perform the material and substantial duties of an emergency room doctor. This should be regardless of whether the individual is working in a new occupation, even if the new occupation is as a general practice physician, such as an internal medicine doctor, primary care physician, hospitalist or the like. Of course, many times disability insurance companies will deny total disability claims filed by an emergency room physician if they are not handled properly from the beginning by the physician, and litigation will become necessary to achieve a proper result.

Disability Insurance Denial Answers

Insurance Companies such as Aetna, Assurant, Berkshire, Cigna, Guardian, Liberty Mutual, MetLife, Reliance, Standard, and Unum are well-known for unfair and biased claims review processes, misrepresenting the facts, and for denying valid disability benefit claims. Under the terms of most disability policies and the law, insurance companies are obligated to fully and fairly review each case, engage in proper investigative methods, and timely pay claims to those insureds who are unable to perform the material duties of their occupation and/or any occupation.

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