In possession of five insurance policies from Northwestern Mutual Life Insurance Company, Frank De Jong and his New Jersey disability attorney were forced to take the insurer to court as a last resort for De Jong to collect his disability benefits. Filed on July 5, 2011 in the United States District Court for the District of New Jersey, the complaint against Northwestern Mutual requests that the Court order Northwestern Mutual to pay damages to De Jong for "breach of contract, together with interest, attorney’s fees and cost of suit." De Jong and his disability attorney are asking to recover compensatory, consequential and punitive damages from Northwestern Mutual.

Painter Purchased Five Individual Disability Insurance Policies from Northwestern

In June 2006, De Jong purchased several individual disability insurance policies from Northwestern Mutual. In those policies, the definition of disability that the insurance company provided De Jong stated that "the insured is totally disabled when both unable to perform the principal duties of the regular occupation and not gainfully employed in any occupation." De Jong submitted an application to claim his disability benefits to Northwestern Mutual on April 10, 2010. His complaint was that since he was experiencing "a constant ringing in his right ear, severe to profound hearing loss bilaterally, and an inability to concentrate and focus due to the constant distraction of the ringing noise and balance issues due to loss of equilibrium, he is unable to perform the required duties of a painter." De Jong’s profession as a painter requires him to use ladders, climb scaffolds, and work in and around heights, and he is unable to perform those duties as a result of his present condition.

De Jong and His Disability Attorney File a Complaint against the Insurer for Breach of Contract on Two Counts

Stating that De Jong "was capable of performing his own occupation" in a letter dated November 30, 2009, Northwestern denied De Jong his long term disability benefits. Having provided Northwestern with appropriate proof of his condition, De Jong and his attorney contend in the First Count of their complaint that Northwestern breached their contract of disability insurance with De Jong. De Jong was up to date in his payment of insurance premiums and accuses Northwestern of breaching not only its contractual obligations but its obligation of good faith and fair dealing in the denial of De Jong’s disability benefits.

In the Second Count of the complaint, De Jong and his attorney claim that Northwestern breached its contractual obligation by denying De Jong’s claim for loss of business income. Even though De Jong provided the insurer with proof of the loss of business income as a result of his disability, the insurer stated that in its opinion, De Jong’s "loss of business income was not the result of any disability."

A complicated issue, De Jong v. Northwestern Mutual Life Insurance Company may prove to be a precedent-setting case for solo business owners everywhere. 

About the author: Gregory Michael Dell is an attorney and managing partner of the disability income division of Attorneys Dell & Schaefer. Mr. Dell and his team of lawyers have assisted thousands of long-term disability claimants with their claims against every major disability insurance company. To request a free legal consultation call 800-411-9085.