Category: Insurance lawyers

claims

Claims: How Much Documentation Will the Insurer Require from Me?

Even in a world that is becoming increasingly wireless—and paperless—there is still plenty of paperwork and documentation required for different services, whether you are operating on the business or personal level. From beginning to end, insurance is about the paperwork; in fact, that’s really all you will have to show for your expenditure as you walk away with a policy in hand, and the cost could be quite substantial for something that is virtually non-tangible.

Read Your Policy & Know What to Expect

Whether you are purchasing car insurance, life insurance, or a variety of different types of business insurance, documentation is required in the beginning and there may continue to be different requests and requirements. When it comes to a claim though, the insurer may ask for a surprising amount of information. This could be even further exaggerated if the insurer has another agenda, whether they are trying to rule out fraud or are practicing in bad faith and hoping to inconvenience you to the point of dropping a case.

A car accident case is usually a good example. If you were injured due to the negligence of another party, don’t be surprised to begin hearing from the other motorist’s insured almost immediately. You may have barely made it out of the doctor’s office or emergency room and into the garage before your phone starts ringing. If you are suddenly dealing with a physical challenge due to injury—and one that could be quite serious and even long-term—it may be extremely difficult to deal with the number of questions an adjuster wants to ask. They may also be trying to trip you up as you discuss the facts and then hope to pin some of the blame for the accident on you. Because of this it is in your best interest (and that of any potential legal case) to refer all insurance calls to your car accident or injury attorney.

Be Suspicious if the Insurer Asks for Inordinate Amounts of Paperwork

In an example like a car accident claim, you can expect requests for paperwork such as a copy of your license and insurance coverage, the accident report filed by local law enforcement, and any medical records. An experienced attorney will be well-apprised of the usual documentation required, and at alert if the insurance company seems to be trying to intimidate you into dropping the case or deny the claim altogether. For other types of insurance—and especially those with large settlement amounts at stake, the insurer may begin reaching far outside the realm of normal paperwork, asking for tax returns and other financial records as they build a case to show fraud or another problem that could feasibly cause the case to be dismissed or allow them to deny quickly.

The amount of information that can be requested is sometimes not clear, and you may have trouble finding that specifically outlined anywhere. If you suspect bad faith practices, call the Bolender Law Firm as soon as possible for help. Other red flags to watch for are lack of an investigation into the case, constant delays that don’t seem to have any rationale behind them, as well as an outright lowball offer.

Contact Us for Help!

If you need help reviewing your insurance policy, or if you suspect your insurance company may be denying your claim in bad faith, contact the attorneys at the Bolender Law Firm.  If a dispute over a claim cannot be easily resolved through a call or written communication, our attorneys will advocate on behalf of policyholders through litigation, arbitration, or non-binding mediation. Our attorneys are experienced in representing clients in state and federal courts, at both the trial and appellate level. Call us at 310-320-0725 now or submit an easy consultation request online. We are here to help!

Fighting insurance companies

Fighting Insurance Companies When They Want to Underpay—Or Not Pay at All

If you have filed a claim against and are having trouble getting paid, it may feel like a real struggle, as is common in fighting insurance companies. Not only that, you may already be dealing with enough stress, depending on why the claim was filed. You may have endured a car crash or motorcycle accident and need to recuperate or learn to adjust to an injury that has left you permanently debilitated. There may have been damage to your business causing you to lose significant income or perhaps there was catastrophic damage to your home. These challenges may leave you drained in many ways—and having to worry about whether the insurer is going to pay a valid insurance claim (and when) can cause enormous strain.

Refer All Adjuster Questions to Your Attorney

The claims process can be simple in many cases, while others require more complex investigations due to the nature of the incident. Adjusters are brought in to compile and evaluate information regarding what happened, whether it was a personal injury, property damage, or more. While they may hope to interview you (as well as any witnesses who were on the scene and proffered up contact information), it is in your interest to work with a skilled attorney who can handle the insurance company. And it is best to do so from the onset.

While the adjuster’s questions may seem harmless enough at first, keep in mind that their agenda is to see that the insurance company pays out as little as possible. They may begin delving much deeper, asking when you received medical care (examining how long it took you to seek help), requesting release of medical records, all related reports, and they may even want to tape your conversation(s). Hopefully all these requests, and all communication, are referred to your attorney who can decide what it is appropriate to share.

The Adjuster Assesses & Comes Up with Settlement Amount

Afterward, the adjuster should arrive at a figure for a settlement. If you are working without an attorney, you may find that they offer you a very low settlement; and while there may be greater respect from the insurer toward your case if you have legal representation, the adjuster may still offer a very low amount. There are various reasons behind this: that may be all you are owed realistically, they may not have gathered all the proper evidence, or sadly and more likely, it may just be that they are attempting to get out of paying the settlement you are owed. Insurance companies make billions of dollars in profits each year, and unfortunately, they are not your friend.

Contact Us for Help!

Even worse, the insurer may delay your claim or deny it altogether. If you need help reviewing your insurance policy, or if you suspect your insurance company may be denying your claim in bad faith, contact the attorneys at the Bolender Law Firm.  If a dispute over a claim cannot be easily resolved through a call or written communication, our attorneys will advocate on behalf of policyholders through litigation, arbitration, or non-binding mediation. Our attorneys are experienced in representing clients in state and federal courts, at both the trial and appellate level. Call us at 310-320-0725 now or submit an easy consultation request online. We are here to help!

Insurance company investigations

Insurance Company Investigations: How They Are Performed

If you have been injured or forced to file a claim with your insurance company for any number of reasons, most likely you want to see action as soon as possible, in the form of insurance company investigations. This could be the case for many different types of claims, but incidents where someone has been injured—and perhaps seriously—tend to be the most sensitive. Finances may be extremely tight too if you have been harmed due to the negligence of others and suddenly cannot work or must stay home to care for a family member who is suffering.

Car accidents are a typical example. If you were hit by another motorist who may have been reckless for any number of reasons ranging from distracted driving to drunk driving, drowsy driving, speeding, or more, it could be that the insurance adjuster for the other party is on top of things at an alarmingly fast speed. They may be calling immediately, asking for police reports, medical documents, and squeezing you for information regarding any injuries. Although they are doing their job and can be quite good at seeming like they care about your well-being, most adjusters are skilled at what they do. This often includes receiving extra compensation for settling for as little as possible and clearing out cases as quickly as possible.

Investigation begins with the obvious, in finding out details about the case. And while the adjustor may want to get much of the information from you, this is where you will need to refer them to your auto accident attorney (or, if the insurance agency is denying your claim in bad faith, consult with a skilled insurance lawyer from a firm like the Bolender Law Firm). Along with information from law enforcement who were on the scene and any medical professionals who treated you, the adjuster will probably want to talk to witnesses if contact information is available for any of them too. They may request photos from the accident as well as asking to look at your car and take more pictures for their files. The adjuster will often visit the scene of the accident for further documentation.

Once they have finished their investigation, the adjuster will arrive at a settlement amount. This may be much less than what they should pay you, which is why you need an experienced attorney to represent you. If the insurance company does not seem to be investigating the accident or if they have presented you with a lowball offer, there is the possibility they are acting in bad faith. If you suspect your insurance company may be denying your claim in bad faith, contact the attorneys at the Bolender Law Firm.

If a dispute over a claim cannot be easily resolved through a call or written communication, our attorneys will advocate on behalf of policyholders through litigation, arbitration, or non-binding mediation. Our attorneys are experienced in representing clients in state and federal courts, at both the trial and appellate level. Call us at 310-320-0725 now or submit an easy consultation request online. We are here to help!

insurance companies

Insurance Companies and How Specific Parties Are Defined

Insurance may be required in some states for businesses or automobile owners, but most of us realize the value of coverage without having to be forced into buying it from the government or insurance companies—simply because we want to be protected from financial catastrophe, whether in terms of health care during an illness or after an accident, automobile accidents and liability, commercial liability, damage to the home, lawsuits over professional negligence, and more.

Understanding your coverages as well any limits or exclusions is critical. Most of us pay our premiums and sleep peacefully knowing we have insurance in place and a policy sitting somewhere in a drawer or a file. We hope and assume we won’t ever need to file a major claim. And as for that policy sitting in that drawer, it may not only seem like some pretty dry reading, but difficult to understand too. It is a legal contract though, so while the legalese is to be expected, you may have some trouble plucking out the main details that apply to you in the case of a major crisis.

One thing that can be very confusing is understanding how parties are defined by insurance companies and in the insurance policy itself. Mainly, differentiating parties is important for describing who would be getting paid by the insurance company in the event of a claim. It is actually very simple though by definition: the first party is the individual or business purchasing the policy from the insurance company. In such a ‘transaction,’ your insurance company is considered the second party as they take care of following through on the promises outlined in your contract/policy. The third party is another party who you are protecting yourself from, basically, as they may file a claim against you; for instance, if you own a business, there may be a claim filed by a third party if they experience a slip and fall accident on your property.

As the first party (say as the owner of an automobile insurance policy), if you have an at-fault accident where your car needs repairs, you must pay the deductible and deal with the insurance company—as well as repercussions such as increased premiums and possible points against your license. Are you concerned about a recent claim, or are you trying to understand your insurance policy? If a dispute over a claim cannot be easily resolved through a call or written communication, the Bolender Law Firm will advocate on behalf of policyholders through litigation, arbitration, or non-binding mediation.

Our attorneys are experienced in representing clients in state and federal courts, at both the trial and appellate level. Call us at 310-320-0725 now or submit an easy consultation request online. We are here to help!

ERISA

ERISA: Understand How It May Affect Your Benefits

The Employee Retirement Income Security Act of 1974 (ERISA) was enacted solely for the protection of employees and all promised to them from their employers regarding employment. Over the years that has expanded to health plans and other benefits too. According to the United States Department of Labor, ERISA currently covers approximately 684,000 retirement plans, 2.4 million health plans, and 2.4 million additional welfare benefit plans—affecting 141 million workers in the US, with over $7.6 trillion in assets.

Just over half of the employees in our country are being offered retirement and/or health benefits as ERISA is meant to work on their behalf in seeing that pension plans and other benefits are handled responsibly by employers and fiduciaries. If you have a retirement plan or other benefits at the company you work for, ERISA protection should affect you positively as those you work for are held to particular standards in terms of making sure that you not only receive what you were promised, but that they also are completely open in allowing you access to your plans and all that is involved within them.

“More than half of America’s workers earn health benefits on the job, and ERISA protects those too, as well as other employee benefits,” states the United States Department of Labor.

Through ERISA, employers are required to make sure employees are apprised of their benefit plans. ERISA administration also makes the rules regarding items such as:

  • Plan participation for employees
  • Vesting details
  • How benefits accumulate
  • Funding procedures

Accountability regarding fiduciaries is also one of the main requirements issued by ERISA – harkening back to the administration’s original mission to make sure companies do not mismanage plans, leaving employees with little to nothing – or even worse, embezzling money that was supposed to be set aside for pensions and more. There are strict penalties if ‘principles of conduct’ are not followed, meaning that they would have to pay back any lost plan funds. Employees are also imbued with the power to sue over such issues, along with the possibility of being paid through the Pension Benefit Guaranty Corporation if a plan is discontinued.

Whether you are an employer or an employee, you may have numerous questions about the complexities of ERISA and how it applies to you. If your benefit plan has been disrupted or denied, you may also need skilled legal advice form a law firm experienced in both insurance law and business law.

Contact the Bolender Law Firm. If a dispute over a claim cannot be easily resolved through a call or written communication, our attorneys will advocate on your behalf through litigation, arbitration, or non-binding mediation. Our attorneys are experienced in representing clients in state and federal courts, at both the trial and appellate level. Call us at 310-320-0725 now or submit an easy consultation request online. We are here to help!

separation of insureds

Separation of Insureds Clause & How It May Affect You

Let’s face it: the insurance policy is not exciting reading, and many of us overlook it despite the importance such facts (and choices) could play in our future later–with terms like separation of insureds being a perfect example. Filled with legal jargon and long paragraphs that seem to take forever to get to the point, you may find yourself taking a snooze when looking over your policy. It is a critical legal contract though, and one that could affect you and your finances enormously in the future, should the need to file a claim arise. Be sure to understand who and what are covered and for how much, peruse information regarding changes and renewals, and read over any enhancements, riders, or special clauses.

Separation of Insureds Protects Multiple Individuals

The separation of insureds clause may seem complex to understand at first, but basically it means if there are multiple people being insured on the policy, they are each protected separately within the claim. The point is who is being sued, not where the lawsuit is emanating from—as additional insureds are taken care of within your commercial general liability policy. Also known as the severability of interest clause, this part of your commercial policy should state that all provisions will apply to everyone listed under your policy.

Know What Coverage is Required for Your Business

While your coverages for business insurance may vary, California does require you to carry workers’ compensation and unemployment insurance. Comprised of property and casualty insurance, the commercial policy is meant to cover all the physical aspects of your business as well as liability for any harm that may come to you or third parties due to an accident or other injury. Aside from what is required by the state, the rest is up to you and should be discussed at length with your insurance agent. Getting informed about your options and making sure your business is completely covered is vital to your future, as well as those who continue to work for you and may be protected through your policy. You may also need to add more insurance coverage as your business continues to grow over the year. Be sure to review your policies at least once a year and discuss any potential changes with your insurance agent.

Contact Us for Help Now

Are you concerned about a recent claim, or are you trying to understand your insurance policy? If a dispute over a claim cannot be easily resolved through a call or written communication, the Bolender Law Firm will advocate on behalf of policyholders through litigation, arbitration, or non-binding mediation. Our attorneys are experienced in representing clients in state and federal courts, at both the trial and appellate level. Call us at 310-320-0725 now or submit an easy consultation request online. We are here to help!

 

third party insurance

Third Party Insurance: Understanding Bodily Injury Coverage

You may consider yourself an excellent driver and find yourself worrying little as you travel on busy roads each day. Some of us have a short commute, while others are in the car all day for work or perhaps shuttling kids around from school to activities to appointments. If you live in a larger city, there is a lot of ground to cover for all of life’s responsibilities and the car may seem like your home at times; in fact, studies show that not only do US drivers as a whole spend over 84 billion hours behind the wheel each year, they spend 17 hours annually just looking for parking spaces!

And while the government overall—along with city administrators around the country—continually work to improve infrastructure and make the roads safer, traffic accidents and fatalities continue to rise overall, to include greater threat to bicyclists, pedestrians, and motorcyclists too. Negligence may occur due to distracted driving, motorists who are under the influence, drowsy, or those who are reckless in myriad other ways. Car insurance is not just a plus, it could save you from ruin—in terms of your physical and financial health.

For many car owners, insurance is purchased in a hurry as they are buying a new car or moving to a new state. It is easy to go with the required limits and get back to other tasks in your day, but always be aware how your decision on car insurance purchases could affect you later if there were a serious accident. Understanding how you and other parties are protected is key, along with deciding how much bodily injury coverage to purchase.

California is a ‘fault’ state in terms of car accidents, meaning that you must assume responsibility if you have an accident. Liability insurance is required as follows: $15,000 to be paid to one person if they are injured or die, and $30,000 to be paid total if there is injury or death to more than one person. Considering how astronomical healthcare rates can be, if a third party is injured, the bill could be enormous. Speak to your insurance agent about protecting yourself beyond basic limits, as you could be responsible for the medical bill of a third party that far exceeds $15,000.

If you need help reviewing your insurance policy, or if you suspect your insurance company may be denying your claim in bad faith, contact the attorneys at the Bolender Law Firm.  If a dispute over a claim cannot be easily resolved through a call or written communication, our attorneys will advocate on behalf of policyholders through litigation, arbitration, or non-binding mediation. Our attorneys are experienced in representing clients in state and federal courts, at both the trial and appellate level. Call us at 310-320-0725 now or submit an easy consultation request online. We are here to help!

Commercial truck crashes

Commercial Truck Crashes: The Potential for Damage & Injury is Greater

You probably travel numerous roads each day for any number of mundane tasks. While there is the daily commute, other responsibilities call too such as carrying children to and from to school and activities, the endless grocery shopping, trips to pick up a range of different consumer items, and often visits to doctor’s office and other appointments. On most days, the drive will be just as uneventful as the day before, but chances are you will have at least one car accident in your life time. Busy roads, often with a melee of cars, trucks, motorcycles, bicyclists, and pedestrians, can be deceptively dangerous for everyone traveling—and in fact, car accidents and fatality rates continue to rise at an alarming rate, showing a 13 percent increase just over two years.

Trucks Weigh Exponentially More

Just as pedestrians and bicyclists are more vulnerable due to the potential of a 4,000-pound car striking them, cars (and everyone else) are at significantly more risk when hit by a truck—and mainly commercial trucks which could anywhere from 10,000 pounds to 80,000. In the case of an accident where a large truck hits a car, the collision could be much more complex as a smaller vehicle could be completely crushed, resulting in serious injuries if not death. There may be trailers involved and 18 wheels to contend with as trucks jackknife or contort with the pressure of a crash. Along with that, there is the concern of the truck’s contents at the time of an accident. While there may be many pounds of inventory, serious environmental hazards could arise with a chemical spill or other toxins.

Injuries in an Accident with a Truck Can Be More Serious or Fatal

If you were harmed in an accident due to negligence on the part of a commercial truck driver (or any other motorist), you could have sustained major injuries (brain injuries, spine and neck injuries, broken bones, and more are common) and been out of work temporarily or permanently. An experienced injury attorney should be the one to speak with any insurance adjustors who may call—and especially if they are prying for information or offering you a quick settlement. Keep in mind that their goal is usually to pay out as little for your accident as possible—and to tie up the case with as little time and effort as possible.

Contact Us for Help Now!

If you suspect your insurance company may be denying your claim in bad faith, contact the attorneys at the Bolender Law Firm.  If a dispute over a claim cannot be easily resolved through a call or written communication, our attorneys will advocate on behalf of policyholders through litigation, arbitration, or non-binding mediation. Our attorneys are experienced in representing clients in state and federal courts, at both the trial and appellate level. Call us at 310-320-0725 now or submit an easy consultation request online. We are here to help!

 

Policyholder issues

Policyholder Issues: Why is the Insurer Going to Such Lengths NOT to Pay?

At the time you purchased a policy from your insurance company, chances are the experience was quite positive as you dealt with an upbeat insurance agent who listened to your needs and any policyholder issues, put together a package that sounded just right for you, and then took a check as you signed away. The policy got tucked away in a drawer somewhere in the home or your office, and as you paid your premiums monthly, quarterly, or annually, you were able to sleep at night with the peace of mind in knowing that you were insured. This means that you expected to be covered if you were sick or harmed—and you expected your home, business, and livelihood to be covered also should something go wrong.

Let’s use a car accident as an example. This is a typical area where insurance agencies may become aggressive about not paying out—and especially if it is the insurer for a negligent driver who caused you to become injured or debilitated and may have even been responsible for killing other passengers during the ensuing accident. As slow as they are to pay out, insurance companies tend to be as fast as lightning when it comes to calling after an accident; in fact, you may have not even made it out of the emergency room before adjusters start calling with questions. And while giving out basic information is not too detrimental to your case, it is important to refer any insurance calls to your attorney immediately.

If you do not have legal representation, adjusters may attempt for a free-for-all in gaining information—even asking for medical records and to tape record your conversation. It is important to understand that deep down they are not as friendly as they may seem, seeking any information possible to use against you should a legal case develop due to the accident. As to why they work so hard not to pay you? Even though you may have been severely injured, may be unable to go to work again, and may have had your life torn apart by an accident or other event, insurance companies don’t report billions of dollars in profits each year due to being nice; in fact, their adjusters and other representatives are trained to settle cases quickly, with as little effort and expense as possible. They are often motivated by bonuses and other compensation for keeping company costs down too. Along with that, insurance companies have vast financial and legal resources—which is why you need an attorney if you have been injured due to the negligence of others. And if you suspect the insurance company is practicing bad faith in not paying out a claim, turn to an experienced firm like the Bolender Law Firm.

Are you concerned about a recent accident, or are you trying to understand your insurance policy? If a dispute over a claim cannot be easily resolved through a call or written communication, the Bolender Law Firm will advocate on behalf of policyholders through litigation, arbitration, or non-binding mediation. Our attorneys are experienced in representing clients in state and federal courts, at both the trial and appellate level. Call us at 310-320-0725 now or submit an easy consultation request online. We are here to help!

Homeowner Details

Homeowner Details: What to Know About Your Insurance Policy

Homeowner details can make up a long list, but insurance is usually at the top. For most of us, the home is where the heart is. It is also meant to be a place of security and comfort, a haven from the outside world and work, and a place to lay our heads down at night safely. Aside from other real estate or storage areas, the home usually holds most of our worldly possessions too. The structure is a significant asset itself though—and if you have just purchased a home or had one built, it may be one of the biggest investments you ever make. Protecting it is key, and to do so you need good homeowner’s insurance.

Your insurance agent probably led you through the details of your policy upon purchasing it, but you may have found yourself signing on the dotted line without completely understanding some of the key points. Following are five things you should understand about your homeowner’s insurance policy:

  1. It will be required by your mortgage lender – unless you have purchased your home outright, or have paid it off, homeowner’s insurance will be a necessity before you can close on your home.
  2. Dwelling coverage – this usually covers any damage that occurs to the home, to include other structures on the property as well as the garage area of the residence. This coverage should mean that you have more than enough to pay for construction costs in rebuilding the home if necessary. While valuing the real estate is important, it is critical to consider this coverage in terms of the actual math for doing a rebuild.
  3. Personal property coverage – covering the contents of your home, this part of the insurance kicks in whether your possessions are damaged or lost due to an unfortunate issue such as a burglary. There may be limits on typical items like jewelry, guns, collectibles, and more though.
  4. Liability and medical payments – while this may be one of the items you think about least for homeowners, it is a standard but critical part of your policy. This coverage protects you if someone were to hurt themselves on your property (in a slip and fall accident, for example), as well as paying for medical expenses.
  5. Extra coverages may be required ­– in California especially, be aware that earthquake and flood insurance are not provided in the standard policy, along with coverage for other disasters like landslides or environmental issues. These types of coverage must be purchased additionally, and often there are state plans available for items like flood insurance.

If you need help reviewing your insurance policy, or if you suspect your insurance company may be denying your claim in bad faith, contact the attorneys at the Bolender Law Firm.  If a dispute over a claim cannot be easily resolved through a call or written communication, our attorneys will advocate on behalf of policyholders through litigation, arbitration, or non-binding mediation. Our attorneys are experienced in representing clients in state and federal courts, at both the trial and appellate level. Call us at 310-320-0725 now or submit an easy consultation request online. We are here to help!