We are asked if the insurance company can be “punished” for failure to pay off a rightful claim. Below is an example of that happening. One of the things that a court must consider in these cases is the fact that, if an insurance company doesn’t pay a substantial claim for a long period of time, that company is getting the benefit of holding on to the claimant’s money, including using it operating capital and earning interest from it. Here, there is a disgorgement award ordered — the insurance company not only has to pay out the money that it wrongfully denied a claimant, but it has to pay out profits it received from holding on to that money. In effect, the court is punishing the company for its wrongful act.
If you feel that you have a claim that is being wrongfully denied, contact us right way. We are here to help!
In an ERISA long-term disability (LTD) case, disgorgement refers to the Court ordering the insurance company to pay, not only the claimant’s benefits under their policy, but also profits the insurance company made while denying the claim (and holding onto the money).
On December 6, 2013, the Sixth Circuit Court of Appeals decision in Rochow v. Life Insurance Company of North America (LINA) sent a message that, not only did the Court have the authority to make such an award, but it would use that authority to right what it perceived as a wrong. The basis of the large monetary calculation was ROE, or return on equity. The Court used this method to determine the level of unjust enrichment to the LTD insurance company and then returned the determined amount to the claimant. The Court also appeared to be sending a message to the LTD insurance industry to act in good faith when evaluating a claim, or the Court might make a disgorgement award.
Many ERISA and non-ERISA long term disability claims are wrongfully denied each year. Wrongful denials enable the big insurance companies to hold your money while they seek to make profits the longer they hold your money. If you believe you have been wrongfully denied your ERISA, or non-ERISA, long-term disability benefits, give us a call for a free consultation. You can reach Cody Allison & Associates, PLLC at (615) 234-6000. We are based in Nashville, TN; however, we represent clients in many states. We will be happy to talk to you no matter where you live. You can also e-mail our office at cody@codyallison.com. Put our experience to work for you. For more information go to www.LTDanswers.com.
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