Legal Question in Insurance Law in New York

I have private disability coverage with two companies. one of the questions on the two claim forms ask if I have coverage with another company. Do I have to disclose that information to them? Does this effect my claims?


Asked on 6/16/10, 6:34 pm

2 Answers from Attorneys

Justin Frankel Frankel & Newfield, P.C.

It is important that you answer all the questions truthfully otherwise the insurance carrier my claim that you have failed to disclose material information.

Frankel & Newfield, P.C.

Web : www.frankelnewfield.com

Blog: www.disabilityinsurancelawyerblog.com

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Answered on 6/17/10, 6:36 am
John W. DeHaan DeHaanBusse LLP

Yes, you have to answer that question truthfully. The question is an appropriate and relevant question for the carrier to ask. If you do not answer the question, the carrier can claim that you are not cooperating in the investigation of your claim. If you answer the question falsely, it could be considered fraud.

In any event, at least one of the carriers should know about the other carrier because they ask about other coverage on the application for the policy. So, when you applied for the second policy, you would have needed to disclose the existence of the other coverage.

Also, the insurance companies are almost certainly participants in the Medical Information Bureau (MIB), which maintains the Health Claims Index (HCI). Every time you apply for an insurance policy or put in a health insurance claim (includes disability claims), it gets recorded in the HCI. Then, when you file a claim for disability benefits, most carriers get a report from MIB and learn about the other coverage that way.

The bottom line is that the carriers either know the answer to the question already, or will be able to verify the accuracy of your answers.

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Answered on 6/22/10, 7:50 am


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