Dallas Insurance Claims Attorney | Personal Injury Lawyer Richardson

Category: Bad Faith Insurance

  • Life Insurance Denial Creates Stress in an Emotional Time

    Following the loss of a loved one, you are living in a new world. It is a world without that long-time companion. It is a world without your spouse, a world without the father of your children. And at a more logical level, it is a world without a primary income earner.
    Life insurance is supposed to be an aid in the transitional and emotional time of major loss. When making an insurance decision and purchasing a plan, the issue feels strictly financial. Can you afford the monthly payments? What kind of insurance should you/your family buy?
    When your loved one dies, however, everything—including insurance—can hit you in a more personal way.

    The Money You Need (and Are Owed) Is Being Withheld

    After you lose someone, it seems natural to step back, rest and dwell in your feelings. Through the sadness and fear, however, you must push on to address post-death formalities. Planning a funeral, for example, could be the most daunting task you face.
    You must organize a very important ceremony to honor your loved one while grieving. Funerals can be expensive, however, requiring the funds that a life insurance policy can supposedly provide. According to the National Funeral Directors Association, the median cost of a traditional funeral with a viewing in 2016 was more than $7,000. This cost doesn’t include a grave stone, either.
    Many people do not have that much money readily available. They believe that is why they invested in a proper life insurance plan. When your insurance provider denies your life insurance benefits, not only are you left grieving your loss, but you are stressing out about how to afford an honorable funeral and resting place for your family member.

    Don’t Just Accept Life Insurance Denial Out of Vulnerable State

    Out of vulnerability and inexperience in such matters, some who face the denial of life insurance benefits might shy away from fighting for their money. Thankfully, talking to a law firm experienced with bad faith insurance claims can instill some bravery through knowledge to a victim of insurers acting in bad faith.
    An attorney helping you fight for your insurance benefits will try to spot and combat bad faith amid the following common denial reasons:

    • The insurance premiums were not paid or current.
    • The deceased died due to suicide less than two years after the purchase of the policy.
    • The person subject to the life insurance claim lied about their health in order to be insured.
    • The deceased lost his or her life while breaking the law.

    Insurers might represent themselves as though they are certain about any of the above scenarios. They can make you feel hopeless. Don’t let them.

    Get Help, Protect Your Rights, Honor Your Family

    The above claims for denial don’t just pack a potential financial punch, but they can be an emotional punch to the gut of someone trying to grieve, make funeral arrangements and afford a normal life after someone special is gone. A legal fight for insurance benefits can seem overwhelming and insignificant when faced with mourning. Contact The Fell Law Firm. Let a legal team fight beside you against bad faith insurance tactics.

  • 3 Signs Your Insurance Company Just Wants You To Go Away

    Insurance companies often foster reputations for being less-than-generous or downright stingy. Unfortunately, you can’t entirely foresee how some businesses will treat you when you turn to them for help, including your insurance provider. It’s not until you must make a claim that you find out how accommodating—or not—your insurer really is.

    Signs You Need a Lawyer to Help With an Insurance Claim

    Here are some examples of situations where hiring an attorney can help keep the insurance company from taking advantage of you while you are desperate, ill or grieving.

    • Rejecting your claim: Certain companies reject more legitimate claims than others. Oftentimes, only an attorney who understands the laws that companies must follow in order to operate in Texas can convince the company to reconsider its harsh insurance claim denial without facing a lawsuit.
    • Paying your claim slowly or paying only part of your claim: Another way that insurance companies can hang onto their money is to delay your payments for months or pay less on each payment that they are supposed to make. They know that most people have neither the time nor the resources to follow up time and again when they do not receive the promised amount, or they don’t send the payment on time.
    • Failing to investigate your claim: The longer it takes an insurance company to investigate your claim, the more likely it will be that the investigation will come out in their favor. Evidence gets lost, witnesses disappear, and claimants even die, often making a claim worth less than when the claimant was living. As cruel as this sounds, it happens often. Hiring an attorney as soon as possible can prevent your claim (and the evidence that documents your case) from getting washed away or gathering dust on an adjuster’s desk.

    Don’t Become a Victim of Your Own Insurance Company’s Bad Behavior

    We understand that what you’ve just experienced to file an insurance claim can overwhelm you. The small print in your insurance contract is overwhelming, too. Don’t be afraid to pick up the phone and ask us for help. Let us take the burden of dealing with your insurance company off your shoulders.
    Make one call to set up an appointment and we’ll talk it through with you.

  • The Most Common Reasons for Commercial Insurance Claim Denials

    Commercial insurance protects businesses in the event of property damage from fires, water leaks, vandalism, and other events. It should provide the financial resources for restoring the business to pre-loss conditions while maintaining it during repair.
    Unfortunately, many business owners never receive this compensation. Their insurers deny their commercial insurance claims, refusing to pay the proper amount.

    Top Causes for Insurance Claim Denials

    Here are some of the most common reasons that insurers deny commercial insurance claims:

    • Alleged delays in filing the claim: Most policies have strict time limits for reporting commercial property damage to the insurer. A delay in reporting can become a reason for the insurer to deny the claim.
    • Alleged premium payment lapses: Even a small lapse in payment can become a reason for an insurance company to deny a business insurance claim. Ensuring continuous coverage is key to protecting your business.
    • Insufficient documentation: Careful documentation is necessary to establish that the damage occurred. For that reason, many business owners prefer to work with a lawyer from day one. Business owners can get the guidance they need to provide the right information the first time—avoiding any unnecessary delays or denials. (Of course, even when business owners provide the right information, insurers sometimes act in bad faith and say they did not receive it. If this has happened to you, call an attorney.)
    • Exclusion clauses: Some business insurance policies exclude certain types of damage, like flood damage, for example. If your policy excludes the type of damage you experienced, your insurer will likely refuse to cover it. It’s critical to thoroughly read and understand your policy before harm occurs.
    • Failing to mitigate the damage: Most insurance policies require business owners to take certain steps to limit the extent of the damage. If they allegedly do not, the insurance company may not compensate them for all of the harm done to the property.

    Has Your Insurer Denied Your Claim?

    No matter why your insurance company denied your commercial insurance claim, one thing is true: it is critical to take decisive action quickly. You only have a limited amount of time to appeal the denial or you may waive your right to take action. Your lawyer will need time to assess the situation and put together a strong argument on your behalf. It is important to act as soon as you anticipate trouble.
    We are standing by now to help. To talk with an attorney at The Fell Law Firm in Richardson, call 972-450-1418. Consultations are confidential.

  • Denial of Insurance Claims for Losses From Theft and Other Crimes

    If your business experiences losses because of theft and your commercial policy covers theft or other crimes, your first call should be to your insurance carrier to learn about your coverage details. Commercial theft insurers can tailor a policy to fit your type of business, so you may or may not have coverage for a specific type of theft crime.

    Insurance companies write theft coverage policies to cover crimes such as:

    • Employee theft, sometimes called employee dishonesty. These policies often have exclusions, so you will want to check the details carefully. For example, a policy might not cover dishonest acts by a partner or owner.
    • Forgery such as bad checks
    • Property theft, often referred to as shoplifting in retail environments. Note: This type of coverage can also protect against employee theft of inventory.
    • Credit card fraud
    • Theft of money and securities
    • Burglary or robbery by employees or others
    • Computer fraud
    • Business identity theft
    • Funds transfer fraud
    • Counterfeit money

    Businesses whose insurance company denied their theft loss claim—even when they have theft insurance—should find out about their options. They could be victims of insurance bad faith.

    Issues in Commercial Crime Insurance

    It is important to have objective advice about your commercial theft coverage, as there are exclusions that can invalidate your insurance. For example, if you know an employee has committed theft, the insurer would automatically cancel coverage on that employee. Other issues that can complicate a theft claim include:

    • Whether you are covered for the time when the theft occurred or when you discovered the loss; these could be two different dates.
    • The difference between your employee and an employee of a service provider, such as a cleaning crew or plumbing company. Your employee theft policy would not cover losses resulting from theft by a contractor’s employee.
    • Whether the loss is the result of theft or vandalism.
    • Having the assistance of a commercial insurance lawyer who understands issues such as these can help you reach the best outcome with your insurance company.

    Contact Our Attorneys for Help if Your Business Theft Claim Was Denied

    If your insurance company wrongly denied your theft claim, call our law firm for help. We can help you recover your losses. We can also review your coverage to make sure you have the right provisions in your theft or crime policies. Contact our commercial insurance lawyers to learn about your options when an insurance carrier denies your claim.

  • A Commercial Insurance Claim Denial Is Not a Cost of Doing Business

    If your commercial insurance carrier denied your claim, you are not alone. Businesses regularly lose millions of dollars because of denied insurance claims. Moreover, businesses whose carriers denied their insurance claims lose more than money. They expend time and effort fighting their insurance carrier—time and effort that could be used to run the business.

    Common Commercial Claim Denials

    Although businesses can insure and submit claims for almost any aspect of their operations, they most frequently experience losses such as:

    • Hail damage
    • Wind damage
    • Tornado damage
    • Fire damage
    • Commercial fleet damage and liability
    • Theft
    • Vandalism

    When an insurance company denies claims for covered events such as these, the business faces the very loss it was trying to prevent by acquiring the commercial insurance coverage.

    Fighting the Commercial Insurance Carrier After a Denied Claim

    There is a process for fighting a denied claim. Briefly, when a commercial insurance carrier denies a claim, a business should:

    • Review the denial notice to identify the alleged reason for the denial. The most common reasons for denying a claim are lack of timeliness, uncovered injury or loss, suspicion of fraud, and exceeded coverage limits.
    • Prepare an appeal. First, review your policy to be sure you have met the criteria for timeliness and you understand any coverage limits and claim procedures. Your appeal should indicate why the event in question should be covered by the policy. Be sure to include any other evidence that was not part of the initial claim.
    • Sue the insurance company. If the carrier continues to deny your claim after an appeal, you can sue the insurer in civil court for breach of contract or bad faith.

    Contact Our Lawyers for Help if Your Commercial Claim Was Denied

    If you chose to sue your insurance carrier after it wrongly denied your claim, you will need to work with an experienced attorney who understands Texas insurance law. Moreover, even if you are not yet at the lawsuit stage of the process, you may wish to seek a lawyer’s advice about your options when an insurer denies your commercial claim.
    Fighting insurance companies is time-consuming and expensive when you don’t do it every day. Contact our insurance attorneys for advice and action when a carrier wrongfully denies your claim.

  • 16 Tell-Tale Signs of Bad Faith Insurance

    Texas law requires that insurance companies owe their customers a common law duty of good faith and fair dealing. In addition, state statutes require that insurance companies that sell policies of any kind to:

    • Be truthful about facts or provisions of a policy. In other words, don’t say that something is covered when it is not, or vice versa.
    • Seek a fair settlement when it is obvious that the insurance company is liable
    • Investigate a claim promptly before denying it. Do not just say “No.”
    • Explain clearly why a claim was denied

    The notion of good faith in Texas is based upon the superior position of insurance companies compared to their insureds. The companies have superior knowledge, resources, and legal firepower that makes it easy for them to obtain and exploit an unfair advantage over their customers. That is why the law requires them to act in good faith—otherwise, they would use their advantageous position to deny more claims and make more money.

    Don’t Ignore These Signs of Bad Faith After Filing an Insurance Claim

    How do you know if your insurance company is treating you in bad faith? There are many clues that should make you suspicious and send you off to an attorney to learn about your rights. These include:

    1. Delaying the resolution of your claim without explaining why
    2. Not investigating promptly and thoroughly
    3. Not acknowledging that your claim was received
    4. Not offering a timely settlement when insurance company liability is obvious
    5. Not notifying customers of policy changes that could have affected them
    6. Offering or making payments without explaining what they cover
    7. Not explaining how the company handles appeals
    8. Not explaining required arbitration
    9. Requiring too many unnecessary forms from doctors and others
    10. Not explaining the reason for denying a claim
    11. Not explaining why a compromise amount was offered
    12. Withholding or misrepresenting claim information
    13. Trying to shift liability onto an insured by making untruthful charges such as arson or drunk driving
    14. Telling the inured that a lawyer is unnecessary
    15. Trying to discourage claims with threats and abuse
    16. Misrepresenting the claim’s value

    Insurance companies are masters of the strategy, “Delay, deny and defend.” They use tactics such as these to protect their profits and shareholders. However, insureds can fight back by staying alert and recognizing symptoms of bad faith such as these.

    Is Your Insurance Company Acting in Bad Faith? Call an Attorney to Find Out.

    Contact our lawyers to learn about your legal rights and options if you suspect your insurance company is giving you the runaround. You may be able to make a bad faith insurance claim that could not only obtain a fair settlement amount but also cover your related costs. Call our bad faith insurance attorneys for more information.

  • Caution: Having Health Insurance Doesn’t Always Protect You

    Having insurance brings peace of mind. You don’t need to worry about getting sick or being injured. Until that is, the insurance company denies your claims. At that point, your peace of mind can quickly become a nightmare.

    6 Reasons Health Insurance Companies Deny Claims

    If your health claims are denied, your first step is to try to understand the reason for the denial. Here are the most common reasons an insurer denies a health care claim:

    1. The procedure or drug is considered experimental or “medically necessary”
    2. The cost of the treatment is greater than the limits of the policy
    3. The treatment, drug or procedure was not pre-authorized
    4. The treatment or procedure was specifically not covered by the policy
    5. The claim was from a provider not covered by the policy, often called a “non-network” provider
    6. The claim was not submitted in a timely way

    Your doctor, hospital or the insurance company itself should be able to explain the reasoning behind the denial. Be sure to ask for their reasoning in writing.
    Remember, however, explaining a denial does not mean the action was correct. Once you know why the insurer denied your claim, you can develop a strategy for appealing the denial. All insurance contracts include options for appealing negative decisions.

    Appealing a Health Insurance Claim Denial

    Sometimes, a denied health insurance claim is simply the result of a filing error by the provider. Asking the doctor, clinic, or hospital to correct and refile the claim may take care of the problem. In most cases, you should be prepared for a fight.
    Here are the three main steps to pursuing an appeal of denied insurance benefits:

    1. Send the company notice (writing a letter or using company-approved forms) of your intent to appeal. That should be sent within 180 days after your claim was denied. Give the company information about the claim you are appealing and why you think the denial was incorrect. Keep copies of everything related to the claim and appeal, including the explanation of benefits (EOB). If you have a phone conversation related to your claim, record the other person’s name and title. Take notes during the conversation.
    2. If the company denies your appeal, you have the right to have your claim reviewed by a third party known as an IRO (Independent Review Organization). The insurance company must pay for the review and abide by the decision of the IRO. You must receive a determination within 20 days (five days for emergencies).
    3. Consider filing a bad faith insurance lawsuit against the insurance company. Consult a lawyer with experience in bad faith insurance claims to determine whether you have a case. An insurance company may be guilty of bad faith if it refused to accept evidence from you or your provider, substituted its own evidence, failed to investigate, or delayed its decision. Be sure to bring all the paperwork related to your claim to your initial meeting with the attorney.

    Denied by Your Health Insurance Company? Lean on a Lawyer for Help.

    Contact our lawyers for help if your health insurance company wrongly denied your claim. Our experienced bad faith insurance lawyers can advise you about your rights and options.

  • Top 5 Tactics Used by Insurers to Avoid Paying Claims

    Top 5 Tactics Used by Insurers to Avoid Paying Claims

    Despite the marketing they do to make you think that they care, many insurance companies will use every trick in the book to delay paying your claim. In fact, some of America’s biggest and most well-known insurance companies regularly and purposely delay payments, deny claims with for no legitimate reason, and even wait for policyholders to die so that they don’t have to pay claims.

    It is important to become familiar with these age-old, delay-and-denial tactics, so you can identify if and when your insurer is using them against you in your own claim.

    5 Common Tactics Adjusters Use to Avoid Paying Out on Insurance Claims

    Here are some of the most common tactics insurance adjusters use to delay or outright deny paying on your insurance claim:

    1. Denial: Denying claims is one of the easiest and fastest ways for insurance companies to boost their bottom line. The practice of “just say no” to claims is seemingly ingrained in some insurance companies’ culture.
    2. Discriminate by credit score: Few people realize that your credit score affects your insurability, what you pay for insurance premiums and can even prevent you from obtaining insurance altogether.
    3. Delay and obstruct claims until the claimant gives up or dies: For many policyholders who purchased long-term care insurance, getting the insurance company to pay has been a nightmare. Customers report having to call insurance companies multiple times and resending documents multiple times. Companies then say that you filed your claim too late and will deny the claim, knowing that the policyholder will either give up and go away or is old and frail and will die soon.
    4. Retroactively cancel policies: Obamacare effectively prevents insurance companies from denying coverage based on preexisting conditions. Now, some insurance scour coverage applications and medical records to find insignificant inconsistencies, claiming application fraud and then cancelling coverage.
    5. Cancel policyholders for simply making a call about a claim: Learning that making a call about a claim might put them in a worse situation surprises most policyholders. If you have a claim for property damage, but decide to pay for the damage yourself, the insurance company may treat your inquiry as a claim and try to cancel your coverage.

    This Really Is a Case of David vs. Goliath

    The insurance industry in the U.S. has amassed assets worth trillions of dollars and pays its CEOs more than almost any other industry. One big reason they can accumulate so much wealth is because they cut back on or completely deny payments to their policyholders. The reason for this is simple: a lone policyholder has an uphill battle facing a corporate insurance company. That is why it becomes so important for individuals to seek legal help when dealing with insurance companies.

    If You’re Getting the Run-Around From Your Insurance Company, We Can Help

    Contact us for help filing for the benefits you deserve from your insurance company. We have years of experience helping people who have a rightful claim to their policy benefits.

  • Understanding depreciation and cost of damage

    Understanding depreciation and cost of damage

    When Texas residents incur property damage, they may naturally assume that their insurance company will cover the damage. What people may not realize, though, is that they are responsible for determining the cost of the damage their property has incurred. It is important for people to understand the idea of depreciation and how it affects their property.

    In order to estimate the cost of property damage, people typically need to establish what has sustained damage. According to State Farm, people should inspect both the outside and inside of their house and put together a list of the items which are damaged. When homeowners create this list, it is recommended that they include information such as how much an item cost, how old it is and where they bought it, as well as list model numbers and brand names.

    In order to be reimbursed for replacing damaged property, homeowners need to understand both the value of their property as well as how this value has changed. United Policyholders says that wear and age can cause your property to decrease in value, and this decrease is called depreciation. Although people might like the idea of set rates of value and depreciation, the process usually does not work like this. Instead, homeowners and their insurance companies can sometimes have different ideas about how much something has depreciated. This can be important because an insurance company may consider some depreciation to be excessive, and this affects the amount people receive after replacing their property.

    Because homeowners play a large role in determining cost of damage, it is important for them to understand that an item’s age does not always affect the value. Instead, people should consider how much use an object has experienced. If homeowners feel that their insurance company is disregarding their estimations of value, they may want to speak to an outside party.

  • 4 times to contact an attorney regarding your insurance claims

    Any situation involving an insurance policy and/or claim has the potential to be frustrating. Whether you are figuring out the coverage that you need or disputing a delayed payout, there is a lot on the line and the insurance agents aren’t necessarily looking out for your best interests.

    With this in mind, understand that you do not need to wait until a situation gets bad before you seek legal guidance. Below, we look at four different times it can be valuable to contact an attorney during the insurance claim process.

    1. Before you ever file a claim: An insurance policy is typically going to be long-winded and involve a lot of legalese that is confusing to people without a legal or insurance background. Before signing any document, you can have an attorney review it to look for any holes or problematic terms.
    2. After a physical loss or property damage: Navigating the insurance claims process in light of a serious incident involving your home or car can be overwhelming when you are already dealing with pain, damage to your home and other losses. An attorney can ensure your claim is filed properly and help you secure a fair settlement.
    3. When the insurance company comes back with a settlement offer: If the insurance company offers you a much lower settlement than you expected or denies coverage, then you will want to talk to an attorney about your next steps. This might include negotiating with your insurer or taking the case to court.
    4. If your company cancels your plan or denies your claim: Contract termination or a flat-out denial can be a major red flag. If you believe you have in place a policy that covers the damage suffered but an insurance company says otherwise, examine the situation with an attorney in order to identify any indications of bad faith actions.

    While legal guidance can be essential when a dispute arises with your insurance company, you don’t have to wait for that to happen to assess your legal situation. You can reach out for guidance and support at any stage of the insurance claim process to protect your rights and seek the coverage and compensation you deserve.