Sunday, 31 July 2011
Car Insurance Claim Denied: What to do
There are many reasons a car accident claim can be denied, valid or not. If your car insurance claim was denied, take note of the reason(s) given in the insurance company’s denial letter. Then take out your insurance policy and begin reading. The denial could be an error based on a lack of complete information or misinformation. But it could also be a correct determination by the insurance company.
Some common reasons for denial are:
- No car insurance coverage was purchased for the claim presented. For example, if you drive an older vehicle, you may carry only liability insurance and have no collision coverage because it is expensive. A claim under your policy for damage to your own vehicle will rightfully be denied.
- You made an Uninsured Motorist Claim under your policy and it turns out the other party to the accident was insured.
- You do not qualify as a named insured under the policy. For example, you are a teenager and you are specifically excluded under your parents’ policy because your parents do not expect you to drive their vehicle.
- Your coverage has lapsed because you failed to pay your premium before the end of the grace period.
- The amount of damage claimed exceeds your policy limits and the insurance company will not cover the excess.
- You bought a new car and failed to notify the insurance company to add it to the policy within the specified time given in the policy.
If, after reading the insurance company’s reasons and reviewing your policy, you still believe coverage has been wrongfully denied, there are some steps you may take to try to remedy the situation. You have certain rights under your policy and under state law. Your insurance company has a duty to fairly and promptly settle your car accident insurance claim in good faith.
Steps you can take if coverage has been wrongfully denied:
- Write back to the insurance company to tell them where their mistake is and provide them with documentation to support your response.
- Appeal the company’s decision to the State Insurance Commissioner.
- Hire an insurance bad faith attorney to discuss the error with the insurance company.
- Sue the insurance company for bad faith, breach of contract, and/or violations of your state’s insurance code.
If the insurance company realizes its mistake, or you are correct in that the adjuster made an error, they will reopen your claim and move forward with their investigation. Where you don’t understand their reason for denial, ask for clarification. It would be wise to consult an attorney to make sure they are not erroneously denying your claim.
CAUTION: Your insurance company is required to act in good faith when handling your car accident claim. If the insurance company unnecessarily denies your claim or fails to promptly settle it, you can sue them for bad faith, breach of contract, and violations of your state’s insurance code. It is crucial that you seek out anauto accident attorney who is experienced in insurance coverage litigation if you believe your insurance company is not handling your claim fairly.
Note that if your car accident claim is with the insurance company for the other driver involved in the car accident, a failure to settle promptly or fairly is not a denial of the claim. You should contact an attorney to either negotiate a settlement for you or to file suit against the responsible driver. Under some circumstances and in some states, you may also file a complaint with the State’s Department of Insurance for Third Party Bad Faith. Seek advice from an attorney to see if yours is one of those states.
Saturday, 30 July 2011
When Your Insurance Company Won’t Pay: 12 Tips
By Mary Shomon, with Dr. William Cline
1. Don’t assume that the first “no” you receive is final.
About 10 percent of all insurance claims are unjustly denied but less than 1 percent of people making insurance claims even question their insurer when their claim is denied. The majority of policyholders who do contest their cases either win their cases or improve their settlements.
2. Insist on a written explanation.
Most state laws require insurance companies to provide written explanations of claim denials. Failure to comply may constitute an illegal practice by the insurer.
3. Read your policy carefully to determine if the claim was legitimately denied.
The insurance company may have interpreted a clause in your policy differently from the way you understand it. Respect your sense of fairness and what you expect the policy to cover. If the ruling doesn’t sound fair, there’s a good chance that it isn’t.
4. Do not accept filing errors as ground for refusal.
Always follow your insurer’s instruction for filing a claim. But if you fail to fill out a form correctly, or if you miss a deadline for submitting a claim – even if you are months late – an insurance company cannot refuse to pay an otherwise valid claim unless the company can show it has been harmed by your error or prevented from making an adequate investigation due to your delay.
5. Do your own research to support your claim.
If your insurance pays less than you expected for care provided, check what other doctors in your area charge for the same care. If other doctors charge more than you received, challenge the payment.
6. Ask your insurance agent or group policy administrator at work for support.
The agent from whom you purchased your insurance has a duty to make sure the coverage protects your interests.
7. Contact the insurance company directly.
If your insurance agent or claims administrator doesn’t resolve the problem within 30 days, telephone the insurance company yourself. Be polite but persistent, and keep going up the corporate ladder. Be sure to make a record of all phone calls, including the names and positions of everyone with whom you speak. Save your phone bills that list the calls. Follow up each call with a brief letter stating your understanding of the conservations, and requesting a response within 30 days.
8. Complain in writing if your phone calls don’t work.
Begin with the person who denied your claim, then write to the person’s supervisor. Include your policy number, copies of all relevant forms, bills, and supporting documents and a clear, concise description of the problem. Request that the insurer responds in writing within three weeks. Keep copies of all correspondence. Send letters by registered mail. Explain what negative effects the denial of your claim is having. Use a courteous, unemotional tone and avoid rude or blaming statements.
9. Write a follow-up letter.
If you receive no response, send follow-up letters, with your original letter attached to the insurance company’s consumer complaints or customer service department and to the company president. In most states, failure to respond promptly to letters regarding claims is an unfair insurance practice.
10. Enlist outside help.
If necessary, add pressure from:
1. Don’t assume that the first “no” you receive is final.
About 10 percent of all insurance claims are unjustly denied but less than 1 percent of people making insurance claims even question their insurer when their claim is denied. The majority of policyholders who do contest their cases either win their cases or improve their settlements.
2. Insist on a written explanation.
Most state laws require insurance companies to provide written explanations of claim denials. Failure to comply may constitute an illegal practice by the insurer.
3. Read your policy carefully to determine if the claim was legitimately denied.
The insurance company may have interpreted a clause in your policy differently from the way you understand it. Respect your sense of fairness and what you expect the policy to cover. If the ruling doesn’t sound fair, there’s a good chance that it isn’t.
4. Do not accept filing errors as ground for refusal.
Always follow your insurer’s instruction for filing a claim. But if you fail to fill out a form correctly, or if you miss a deadline for submitting a claim – even if you are months late – an insurance company cannot refuse to pay an otherwise valid claim unless the company can show it has been harmed by your error or prevented from making an adequate investigation due to your delay.
5. Do your own research to support your claim.
If your insurance pays less than you expected for care provided, check what other doctors in your area charge for the same care. If other doctors charge more than you received, challenge the payment.
6. Ask your insurance agent or group policy administrator at work for support.
The agent from whom you purchased your insurance has a duty to make sure the coverage protects your interests.
7. Contact the insurance company directly.
If your insurance agent or claims administrator doesn’t resolve the problem within 30 days, telephone the insurance company yourself. Be polite but persistent, and keep going up the corporate ladder. Be sure to make a record of all phone calls, including the names and positions of everyone with whom you speak. Save your phone bills that list the calls. Follow up each call with a brief letter stating your understanding of the conservations, and requesting a response within 30 days.
8. Complain in writing if your phone calls don’t work.
Begin with the person who denied your claim, then write to the person’s supervisor. Include your policy number, copies of all relevant forms, bills, and supporting documents and a clear, concise description of the problem. Request that the insurer responds in writing within three weeks. Keep copies of all correspondence. Send letters by registered mail. Explain what negative effects the denial of your claim is having. Use a courteous, unemotional tone and avoid rude or blaming statements.
9. Write a follow-up letter.
If you receive no response, send follow-up letters, with your original letter attached to the insurance company’s consumer complaints or customer service department and to the company president. In most states, failure to respond promptly to letters regarding claims is an unfair insurance practice.
10. Enlist outside help.
If necessary, add pressure from:
· Your state Department of Insurance – this is free. The amount of these departments can help varies from state to state. But some states with strong departments (California, New York, Illinois) will mediate your dispute.
· A professional arbitrator.
· A lawyer.
WHEN INSURANCE IS REQUIRED
What to Expect
Congress mandated federally regulated or insured lenders to require flood insurance on properties that are located in areas at high risk of flooding.
Below you'll find the insurance requirements for your flood risk area. If you're not sure which area your property is in, take your Risk Profile to learn more.
Residents of High-Risk Areas
Homes and buildings in high-risk flood areas with mortgages from federally regulated or insured lenders are required to have flood insurance. These areas have a 1% or greater chance of flooding in any given year, which is equivalent to a 26% chance of flooding during a 30-year mortgage.
Residents of Moderate-to-Low Risk Areas
Homes and businesses located in moderate-to-low risk areas that have mortgages from federally regulated or insured lenders are typically not required to have flood insurance. However, flood insurance is highly recommended because anyone can be financially vulnerable to floods. People outside of high-risk areas file over 20% of NFIP claims and receive one-third of disaster assistance for flooding. When it's available, disaster assistance is typically a loan you must repay with interest.
Friday, 29 July 2011
INSURANCE : WE ARE HERE FOR YOU :)
The main aim of this site is providing the best and update insurance information to the customers and insured people around the world. Today when even the top developed countries like USA, UK, Germany, Japan, Australia etc are facing acute need of security and protection of their citizens, where it is observed that mankind is seemed venerable by security, diseases and natural disasters like tsunami, flood, tornado, earthquake and same sorts of accidents then it is very much necessary to make insure the all people for avoiding the potential downfall of the results.
Lack of insurance info has made more sensitivity than the risks. So it was aimed that here we provide all insurances information regarding the day by day coming policies, and products which are offered by the insurance companies. Not only the information of the insurance policies but how to choose the best policy which will suite with your needs and we elaborate the same sorts of issues in our articles. Here we are not advertising the specific company and any product but giving the best options to the visitors.And surely the uniqueness of this site is the comparative studies and situation analysis on the mankind’s needs between matching products.
We are not only highlighting the best insurance products but we are also busying to explore new ideas in which potentially non-insured people can be addressed by various dimensions. With the very update and fresh information, we are continuously receiving feedback from our visitors from every corner of the world. And we believe that this is our reward, and we have proud on it. Beside that in the site you can find easily insurance quotes by the topmost insurance companies of the USA, where you can compare the rates, services and the coverage of your needful product on total free via online. In future we are planning to make a forum, comprised on new insurance agents around the world where they can get the best insurance relate presentations and communication skills by our senior experts on the insurance industry, who have served their best part of age in this field. Hope that you all will like our efforts and it is requested to you that please give us your feedback time to time for setting our goals at very right sides.
Why do we need long-term financial planning?
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Thursday, 28 July 2011
REQUIREMENT OR NEEDS OF AN INSURABLE RISK
Insurance insures only pure risk. But all pure risk are not insurable. Some requirements should be completed before insurance of pure risk.
Here are some requirements or needs of an insurable risk from the view point of insurer or insurance company.
1. Large number of Exposure units
Large number of exposure units is the first requirement of an insurable risk. It may not be similar, but there should be a large group of roughly similar which are under the peril or group of perils. For example , a large number of frame dwellings in a city can be grouped together for purpose of providing property insurance on the dwellings.
2. Accidental and unintentional
Second requirement is that the loss should be accidental and unintentional . The loss should be out of control of insured and fortuitous.
3. Measurable and Determinable
The loss should be both determinable and measurable. The loss should be definite as to cause , time , place and amount. Life insurance in most cases meets this requirement easily. The cause and time of death can be readily determined in most cases , and if the person is insured , the face amount of the life insurance policy is paid.
4. Calculable chance of Loss
The fourth requirement is the chance of loss should be calculable. The insurer must be able to calculate both the average frequency and the average severity of future losses with some accuracy.
5. Economically Feasible Premium
The premium should be economically feasible. The insured must be able to pay premium. The premium paid must be substantially less than face value or amount of the insurance policy.
SOURCE
Here are some requirements or needs of an insurable risk from the view point of insurer or insurance company.
1. Large number of Exposure units
Large number of exposure units is the first requirement of an insurable risk. It may not be similar, but there should be a large group of roughly similar which are under the peril or group of perils. For example , a large number of frame dwellings in a city can be grouped together for purpose of providing property insurance on the dwellings.
2. Accidental and unintentional
Second requirement is that the loss should be accidental and unintentional . The loss should be out of control of insured and fortuitous.
3. Measurable and Determinable
The loss should be both determinable and measurable. The loss should be definite as to cause , time , place and amount. Life insurance in most cases meets this requirement easily. The cause and time of death can be readily determined in most cases , and if the person is insured , the face amount of the life insurance policy is paid.
4. Calculable chance of Loss
The fourth requirement is the chance of loss should be calculable. The insurer must be able to calculate both the average frequency and the average severity of future losses with some accuracy.
5. Economically Feasible Premium
The premium should be economically feasible. The insured must be able to pay premium. The premium paid must be substantially less than face value or amount of the insurance policy.
SOURCE
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