Insurance Claims

Every day, people are injured, people are disabled, people die, people are sued, homes are damaged, and, in each of these situations, there may be an insurance policy that was issued to provide benefits when the bad times came. Unfortunately, insurance company’s smiling salespeople are not the ones you deal with when you have a claim. Too often, people who need the insurance claims process to work for them find that it only really works for the insurance companies. Insurance companies don’t like claims, they like profits. Insurance companies want claims to be resolved as cheaply as possibly or, if possible, not paid at all.

Get The Help You Need

You need a law firm with an experienced track record and a history of results. Our firm has extensive experience in injury and insurance cases.

Do you need help with injuries because of car accident, truck accident or other cause? Is the insurance company giving you the run around? Has your own insurance company failed to pay your valid claim for uninsured or underinsured motorist benefits? Did your business or homeowner’s insurance company fail to pay a legitimate claim? Is your disability insurer not making payments when you need them most? Has an insurance company refused to defend a claim brought against you, denied coverage, or issued a reservation of rights letter? If you answered yes to any of these questions then you have come to the right place. Our law firm focuses its practice on cases involving injuries and insurance.

Types of Insurance Policy Claims That We Handle

There are numerous types of insurance policies that are sold in the United States. Our law firm has experience with claims and disputes involving the following types of insurance:

Automobile Insurance

Each year automobile accidents injure and kill numerous people. Automobile insurance is mandated by every state in the United States, although from state to state insurance policies vary. Unfortunately, not all drivers carry the necessary coverage or any coverage at all. A person injured by an uninsured driver’s negligent operation of vehicle could be left without any viable recourse against the uninsured driver. However, there may still be insurance coverage available to the insured person.

This coverage would include uninsured motorist coverage on your own vehicle, or the vehicle you are driving, as well as your own policies. In addition, drivers that are underinsured or do not have enough insurance to cover their full liability present a special situation. The vehicle you are driving may have underinsured motorist coverage. In addition, other benefits may be available, such as medical payments coverage. Some states also offer personal injury protection coverage (PIP). Our attorneys advise clients as to which coverage is available based upon the relevant facts of the case.

Commercial Auto Insurance

Commercial auto insurance is sold to businesses that operate owned, non-owned, hired, or borrowed vehicles in their operations. Commercial auto insurance may insure one vehicle or a fleet of vehicles. Commercial auto polices include auto liability insurance to protect the insured from any claims by persons injured by the business or an additional insured. An additional insured may include other people or entities such as subsidiaries or affiliates, directors, officers, mangers, and specifically named additional insureds. Other persons such as agents, employees, temporary employees, lessors, or vehicle owners may also be insureds, depending on the policy language and endorsements. These insureds are entitled to the protection of the liability policy if claims arise.

Commercial auto policies also typically include coverage for named insureds and additional insureds, including uninsured motorist coverage, underinsured motorist coverage, and medical payments coverage. All too often insurance companies take aggressive positions and deny coverage to their policyholders when claims arise.

Uninsured and Underinsured Motorist Coverage

Uninsured motorist coverage is mandatory on all insurance policies sold and is a part of every individual and commercial auto policy. Uninsured motorist coverage protects the individuals insured by providing compensation when involved in an accident with a driver who lacks insurance. This coverage also compensates you if you are hurt in a hit and run accident or are struck as a pedestrian.

Uninsured motorist policies may also be stacked on non-fleet polices, so that each coverage paid for can be added together to create a larger sum of total insurance available to compensate you for your injuries. Unfortunately, insurance companies are always attempting to change their insurance policy language to limit or circumvent stacking to save money. It is important to have an experienced attorney review all the insurance involved in any uninsured motorist case.

Underinsured motorist coverage provides for the payment of benefits to the insured when they are injured by a driver who is insured, but the insurance is not enough to cover your losses. Like uninsured motorist coverage, it also covers hit and run accidents and pedestrian accidents. Underinsured motorist coverage can sometimes be stacked, depending on the insurance policy language. Stacking may also be possible if other facts are discovered which can demonstrate an ambiguity or misrepresentation. These facts can include promises made by the insurance company when it sold the policy in company advertising and brochures, if those promises conflict with the policy terms or statements by the companies agents.

Commercial General Liability Insurance

Commercial liability insurance covers the liability of businesses and additional insureds when claims are made against them for bodily injuring people. Commercial general liability insurance covers general causes of liability such as general negligence and premise liability. Commercial liability does not cover most vehicle accidents, but typically covers mobile equipment which can include machinery such as forklifts, cherry pickers, hoists, and cranes. Insurance companies often dispute coverage by adopting strict interpretations of insurance policy exclusions or disputing factual contentions.

Disability Insurance

Some of us think we can work forever, but unfortunately, many people experience illness or injury that causes long-term disability. Many individuals and employers obtain disability insurance which may provide benefits to compensate for the loss that accompanies a disability. Disability insurance can allow you to cope with the financial hardships that arise when injury or illness strikes. Unfortunately, many insurance companies take aggressive positions and attempt to limit or deny policy benefits.

A common tactic is to question the nature or scope of the injury so that the person does not meet the definition of a disability under the policy. Insurance companies may also strictly construe policy terms in their own favor in an attempt to limit the claims they have to pay. Additional complexity can arise, depending on whether the disability policy is subject to ERISA. ERISA, or the Employment Retirement Income Security Act, gives insurance companies and administrators of the plans provided to employees substantial advantages when a dispute arises.

Claims that fall under ERISA are governed by federal law rather than state law, which is generally more favorable for the insured. Federal law not only gives a substantial advantage in claims disputes to the administrator and insurance companies, it also limits the ability to appeal a negative decision and seek review by a court. Timing in these claims is critical, and can be quite short. If your disability insurance claim is denied, it is important to seek immediate legal help. For a free consultation contact us, or to learn more go to our disability insurance page.

Life Insurance

Life insurance provides a death benefit upon the death of a specified person. The terms of the policy can vary greatly depending on the type of life insurance, but all policies provide for a benefit upon death. However, they often limit the type of death that qualifies. In our experience, when a life insurance claim is denied it is because of one of three reasons: claims by the insurer that the cause of death did not qualify under the policy as a covered event or is otherwise excluded, claims that the insured made misrepresentations on their policy application or that the premiums where not paid, or the policy lapsed. Our firm has significant experience in combating insurance company denials of life insurance.

Homeowner’s Insurance

Almost every homeowner in America has homeowner’s insurance to protect their home from losses such as storms and fire. Homeowners who experience a severe or total loss to their home expect their homeowner’s policy to allow them to replace or rebuild their home.

Unfortunately, insurance companies may deny these claims, leaving the homeowner with no home, few personal possessions, and massive debt. The insurance company may give reasons for denying your homeowner’s claim. Common excuses are that the claim is simply not covered by your policy, that you failed to give timely or appropriate notice, that you caused the damage, that the damage was caused by an excluded peril, or that the damage did not exceed your deductible.

How Our Firm Can Assist You

Careful attention to the facts, including the cause of loss and the proof of claim submitted to the insurance company, are necessary to combat insurance company denials. If your claim has been wrongfully denied, you need an attorney to help. Our firm handles homeowner’s claims in cases of severe or total loss storm damage and fire cases. We can review your policy and advise you on your rights and coverage.

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