Wrongful Insurance Coverage Denial, Business Torts and Corporate Fraud

If you have purchased insurance and have made a claim for damages under the policy, you may have a claim for breach of contract if the claim is in your estimation denied without a good reason. If you feel you have been the victim of arbitrary denial of insurance coverage, there is recourse available if all administrative remedies have been exhausted. These contests are typically drawn out, but if the facts are right, the court system does provide an avenue for recovery. Maryland law does not favor suits by an insured against the insurer, but depending on the specifics of the denial, there may be a legally cognizable claim to be advanced.

Disability insurance is an area of coverage that many insurers priced too aggressively years ago and now wish they had made it more expensive. The denial of a claim for disability insurance needs to examined closely, for many such denials can be proven to have been arbitrary. The illegal business practices of the some disability insurers are well-documented.

Many times these denials are the product of a culture of corporate fraud. If so, proof beyond refute is a prerequisite to bringing lawsuit in fraud. This business tort is little more than being tricked intentionally. The difficulty is in proving with particularity the exact communications that took place. When and where they occurred and between whom are facts that need to be proven with particularity as well. That the client actually relied on the misrepresentation is another critical fact to prove with particularity.

If the communications utilized interstate mail, telephone or fax, then the protections of the Racketeer Influenced and Corrupt Organizations Act come into play. This act, commonly known as RICO, permits the recovery of treble damages as punishment to the wrongdoer.

These cases require an attention to detail and ability to network nationally with experts in claims handling and accounting. I posses those qualities.


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