Deceptive Insurance Practices

Sunday, May 8th, 2016

New York has a General Business Law (“GBL”) that imposes liability for deceptive business practices in the conduct of any business, trade, or commerce. GBL 349 has three elements: 1) the conduct must be consumer-oriented; 2) the conduct must be misleading; and 3) the plaintiff must be injured as a result of the deceptive act or practice. GBL 349 permits recovery of up to three times the plaintiff’s damages, and a court can also award attorneys’ fees.

The courts have upheld GBL 349 claims involving many different types of economic activity, and that includes conduct by disability companies. Claimants whose benefits under individual disability policies were wrongfully denied have commenced actions alleging that the disability insurer violated GBL 349.

I represent a 60 year old client who had to stop working as a foreign exchange broker after more than a quarter century following his sixth lumbar back surgery. The Social Security Administration and Reliance Standard quickly found the claimant was disabled from any full time occupation, let alone his own occupation.

Met Life found the claimant disabled from his own occupation, but then refused to pay additional benefits after a few months. I filed an action against Met Life that included a cause of action for GBL 349 violations. Met Life moved to dismiss the claim, arguing that it did not apply where a plaintiff sought benefits under a disability insurance policy. Specifically, Met Life argued that the complaint was merely a private dispute. The court rejected Met Life’s argument on the grounds that the claimant had stated claims that affected the public in general. Therefore, the court held that the claimant had properly stated a cause of action for GBL 349 violations, and denied Met Life’s motion to dismiss.

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