Tag: Insurance lawyers

ERISA: Understand How It May Affect Your Benefits

Posted by Jeffrey Bolender on September 26, 2018 with 0 Comment

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 Clause & How It May Affect You

Posted by Jeffrey Bolender on September 25, 2018 with 0 Comment

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!

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

Posted by Jeffrey Bolender on September 6, 2018 with 0 Comment

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: What to Know About Your Insurance Policy

Posted by Jeffrey Bolender on September 4, 2018 with 0 Comment

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:

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.
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.
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.
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.
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!

Insurance Coverage: Understanding Triggers

Posted by Jeffrey Bolender on August 29, 2018 with 0 Comment

If you have owned one or more insurance policies for a long period of time, you may have been lucky enough never to have to use it or worry about insurance coverage—but on the other hand, you may also wonder if it has been worth it to pay out so many premiums for what could seem like virtually nothing; after all, in many ways insurance is just a concept. After you meet with the insurance agent, discuss options, purchase coverage, and go on your way, you may feel a bit let down to find out all you feel like you received in exchange for your money was a stack of paper that may be difficult to understand.

Of course, the major goal in purchasing insurance is to procure protection in the case of a car wreck, an injury to a third party at your business, a disaster that affects your home—and so much more. Any such incidents could be debilitating to the person filing the claim, but also catastrophic to your finances. There are many reasons that coverage can be triggered, but it all comes down to one thing: the insurance claim.

If you have an occurrence policy, the claim may be that a third party was injured at your business, or their property was damaged. That triggers the coverage as long as the incident for the claim occurred during the time the policy was in force. With a claims-made policy, coverage is triggered if the policy was in force at the time the claim is made, or during an extended reporting period (also known as the tail).

In some cases, there may be a dispute with the insurer over the claim. You may have done everything right, from filling out all of your paperwork clearly and honestly, to paying every premium without fail, and making sure to keep all your policies reviewed and updated on an annual basis. To have a claim not paid promptly after you have held up your end up the bargain faithfully can be extremely disappointing. Seek advice from an experienced bad faith insurance attorney if you are worried about the following, whether it is regarding an injury claim, property claim, or professional liability that could threaten your business or livelihood:

An offer from the insurance company that is exceedingly low
Lack of investigation from adjusters
Delaying in payment for the claim
Outright denial of the claim

Claims Made Policy: Consider This Before Terminating

Posted by Jeffrey Bolender on August 27, 2018 with 0 Comment

While the insurance industry gets a bad rap—and sadly all too often with good reason—you probably usually feel good about knowing you have coverage in place in case something goes wrong, resulting not only in injury but sometimes opening you up to enormous liability too. There is also the possibility that expenses for such a loss could be catastrophic to your finances. Because of that, most of us are relieved to have insurance and the accompanying peace of mind, despite high premiums and the long list of complexities that accompany many policies.

Getting educated about what you need is critical. Although your insurance agent may be able to explain all the details to you, researching different types of coverage and features included in varying policies will benefit you greatly; for example, you may not understand the differences between the occurrence policy and the claims-made policy. The occurrence policy protects you with coverage even if a claim is made later after your policy has been terminated—as long as the claim is regarding an incident that occurred while your policy was in force.

And although you may be tempted to cancel your claims-made policy due to issues such as the need for broader coverage or better service from your insurance company, keep in mind that there are benefits to the claims-made policy that you may miss out on later; for instance, although the claims-made policy usually states that any claim must have happened during the time the policy was in effect only, there is exception to this with the extended reporting period.

Commonly referred to in the insurance industry as a ‘tail,’ you can purchase an ERP as an endorsement with your policy that may last anywhere from one to five years, or sometimes even as long as ten—and although it may be more expensive than the basic policy, it can be extremely effective for professionals like doctors in the case that a malpractice suit or other claims are brought forth after the policy expires. The ERP may also be referred to as optional or supplemental or be listed as a ‘discovery period.’ They may also be included in your original policy, but only for the very short term such as 30 to 60 days.

Insurance Topics: Attempts to Rescind Policies Are Not Always Successful

Posted by rainmakereditor on August 24, 2018 with 0 Comment

As we age and take on more and more in life, financial responsibilities just continue to grow, and insurance topics figure into many conversations. Along with all the typical consumer household expenses (and debt) such as the mortgage, student loans, auto payments, and credit cards that keep us beholden to a range of ongoing payments, insurance is another critical purchase that must be made and then maintained financially; in fact, in some cases—like auto insurance—it is required. But even if law doesn’t force you to purchase other types of insurance, they are critical for financial protection, as well as peace of mind.

Once you have explored all your options regarding an insurance policy, discussed different coverages with your agent, and taken the plunge to buy a policy that seems like a good fit for your needs, you probably feel in control and able to go on about your business knowing that your future is protected in the case of a catastrophe. Other times though, you may feel like you are at the mercy of the insurance company, even when you fulfill everything asked on your end—which mainly means filling out all paperwork truthfully and signing on the dotted line—and paying those premiums (which often may be hefty!) on time.

Frustration usually sets in if you have had a car accident or had a claim for property damage or professional liability, and the insurer is delaying payment or even denying it altogether for a policy that was in effect. And while it is always your option to terminate an insurance policy, you may be surprised to find out that the insurance company can actually attempt to rescind a policy from their end. Usually when something like that happens, the insurance company is claiming that there was incorrect or fraudulent information in the original application for insurance. They may even accuse you of lying or hiding information so that you could have the advantage of seeing a policy go into effect that might otherwise have been rejected.

A successful rescission of your insurance policy by the insurer means that essentially, it is as if it was never put in place to begin with. Your premiums should be refunded, and you should be notified quickly regarding the process. Such activity can be extremely disturbing if a rescission takes place after you filed a claim, and especially if you know you were honest in filling out your application. While the onus is on the insurer to check out your information before putting the policy in place, all too often they may perform investigations after a claim has been filed and rescind a policy to avoid paying out.

If you suspect your insurance company may be attempting to rescind your policy simply to avoid paying for the claim, 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!

Claim Denied Due to the Assault & Battery Exclusion

Posted by Jeffrey Bolender on August 23, 2018 with 0 Comment

The purpose of insurance is very clear, and it is a financial one. In exchange for paying premiums that could be considered nominal in the long run should there be a major claim, you have the security of knowing that you are ‘covered.’ You may sleep better at night too like so many other policyholders do, dealing with all the stresses of home and business, but knowing that if there were an accident, a fire, a negligence claim, or even a major catastrophe, that the insurance company has agreed to take care of you.

The insurance policy can be complicated though, and one or more of yours may be so full of legalese that you feel like you are mired in trying to understand a different language upon reading it. Not only are there the usual basics such as your personal information and general coverage details, but insurance policies are often also full of a wide range of differing explanations of limits, conditions, riders, and endorsements which add extra protection. And although the individual who sold you the insurance policy may be experienced and knowledgeable, the rules of the insurance industry change so often that it is possible they may not even understand the policy fully.

Exclusions are common in insurance policies, spanning nearly every type; for instance, your homeowner’s policy may exclude damage from earthquakes or construction defects, while your automobile policy excludes other limitations regarding traffic accidents. Business and professional liability insurance may be even more complicated though, and there may be exclusions you never think you would have to worry about such as those pertaining to issues like assault and battery.

Assault and battery exclusions may arise in general liability, but usually such a policy is expected to pay claims for any type of bodily injury or property damage. Some insurance policies may clearly state, however, that they will not cover the insured if an assault and battery claim is filed asking for damages due to injuries. While it may seem understandable that the insurance company would want to exclude themselves from paying legal fees and damages for what could clearly be a criminal act, in many other cases the claim could be complicated and the terms ‘assault and battery’ could be used only technically, or as a complete stretch.

Comprehensive Insurance and Collision: Know the Details

Posted by Jeffrey Bolender on August 22, 2018 with 0 Comment

Car insurance (comprehensive insurance, for example) is usually a necessity, and one of the typical financial responsibilities most of us take on as soon as we purchase our first car. Not only can it be expensive in some cases, it can also be hard to understand as you wade through trying to figure out which details you need in a sea of different coverages, deductibles, limits, and so much more. While not every state asks you to carry insurance by law, California does require you to have the following:

Bodily injury liability
Property damage liability
Uninsured motorist bodily injury coverage

And while both collision and comprehensive insurance are optional, most of us have at least one or both; in fact, if you have financed a car they may require that you carry ‘comp and collision’ until the balance of the vehicle loan has been paid off.

No matter what types of insurance you are purchasing, it may be tempting to get the bare minimum with the lowest premiums—and as we all know, even that can be high! Collision insurance is not hard to understand, just based on the term itself. If you collide with someone or something—in an accident—your collision coverage (assuming your policy is in force and there are no other extenuating circumstances) will kick in whether you hit another car, an inanimate object, or even a pothole. Deductibles vary. You may not have one at all, but of course that raises the rate of your premium. If you have a $500 deductible in the case of a collision, you would have to pay that before the insurance kicked in to have your car fixed.

Comprehensive insurance covers collisions with different types of obstacles such as animals or falling objects. Along with that, you also have coverage for theft, vandalism, natural disasters, and more. There are limits as to how much it will cover, and again, you may or may not have a deductible—depending on how much you want to pay for a premium.

If you aren’t sure about what types of coverage are best for you, have an in-depth discussion with your insurance agent and consider how much your car is worth, how much time you really spend on the road, and what your budget can realistically afford, whether you pay your insurance by the year, quarter, or month.

History: The Employment Retirement Income Security Act (ERISA)

Posted by Jeffrey Bolender on August 21, 2018 with 0 Comment

The Employee Retirement Income Security Act of 1974 (ERISA) was enacted, plain and simple, to protect employees. This came about long after egregious acts by employers who mismanaged pensions and retirement plans—leaving long-term, hardworking employees with nothing in some more extreme cases such as that of Studebaker leaving thousands out in the cold in the early ‘60s. Pension reform was needed, but it did take time.

Throughout the years, ERISA has been amended several times as lawmakers work to refine it further to protect individuals in the US looking forward to the benefits they have been promised. And while pensions were not offered or expected by most before 1900, today they are a benefit many individuals seek—looking toward security in their later years. ERISA originally administered to a range of different tax and labor issues for employees and their retirement plans, but over time it has been expanded to include requiring minimum standards for other benefits like health and disability insurance, scholarship programs, training programs, and more.

“ERISA requires plans to provide participants with plan information including important information about plan features and funding; provides fiduciary responsibilities for those who manage and control plan assets; requires plans to establish a grievance and appeals process for participants to get benefits from their plans; and gives participants the right to sue for benefits and breaches of fiduciary duty,” states the U.S. Department of Labor.

Over time, ERISA has grown through critical amendments as well, such as the:

Consolidated Omnibus Budget Reconciliation Act (COBRA)
Health Insurance Portability and Accountability Act (HIPAA)
Newborns’ and Mothers’ Health Protection Act
Mental Health Parity Act
Women’s Health and Cancer Rights Act

Today three different entities administer ERISA: the IRS, the U.S. Department of Labor, and the Pension Benefit Guaranty Corporation. 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.