The Disability insurance company’s

“conflict of interest”

 
 

Frequently, an insurance company has a “conflict of interest” because it’s acting in a “dual role.”  In the first role, the insurance company gets to decide whether to approve a disability claim.  And in the second role, the company has to pay all the disability benefits it approves.  Obviously, the more claims the insurance company denies, the less it will pay out in claims and the more money it will make. 


In these cases, the insurance company’s conflict of interest can affect how the judge views your claim.  In particular, under the U.S. Supreme Court’s decision in MetLife vs. Glenn, and the Ninth Circuit’s decision in Abatie vs. Alta Health & Life Insurance Company, the judge hearing your case can weigh the insurance company’s conflict of interest in deciding whether the insurance company abused its discretion. 


Proving the insurance company’s conflict of interest, however, takes work and skill by your attorney.  Beyond the obvious dual role, your attorney needs to know what questions to ask the insurance company.  But your attorney also has to be prepared to fight the insurance company to get answers, because the company usually won’t want to give any answers. 


 

when an insurance company decides whether to approve a disability claim and also pays the benefits, it has a conflict of interest that may impact your claim

Under the Supreme Court’s “Glenn” decision and the Ninth Circuit’s “Abatie” decision, courts can weigh an insurance company’s conflict of interest when determining whether you’re disabled. 


Patrick has frequently litigated these conflict issues and can answer any questions you have about  your insurance company’s conflict of interest. 

The information on this website is intended to be informational only and does not establish an attorney/client

relationship, nor is it meant to give or be legal advice for a specific matter.  Please do not email or fax information to

Patrick Mause without first speaking or meeting with him because the information will not establish an attorney/client

relationship and may not be kept confidential. Patrick Mause is a lawyer admitted to practice only in Arizona, the Arizona

District Courts, and the Ninth Circuit Court of Appeals.  His office is located at 290 North Meyer, Tucson, Arizona 85701.