July 2010 Archives

July 29, 2010

Car Wrecks and Florida Insurance

You can use all the skill, care and common sense you possess to drive safely, but you can't control the behavior of drivers around you. If a wreck happens, basic knowledge might help you avoid unnecessary hassles. If you're a person who would rather drive to Oregon nonstop than to read your insurance policy or traffic laws, it's time to read this brief tip.

Although the criminal laws could apply if, for example, a drunk driver hit you, most often you're going to have a civil claim either settled or taken to circuit court under civil law. Almost always, the other driver's bodily injury liability coverage under his automobile insurance policy will be responsible for paying for your damages. The law doesn't require the other driver to drive perfectly, only reasonably, to avoid a wreck with you. Here's an example. Let's say you're driving along on Back Beach Road, and you decide to suddenly hit your brakes and dive into the median to go back for something you forgot. The other driver doesn't have to be a mind reader. The law could excuse him for rear ending you after the sudden, unexpected action you took. On the other hand, if he wasn't watching your normal deceleration and rear ends you, he's in trouble.

Sometimes I see people hire the family lawyer who does their wills, real estate matters, and basic contracts to try to handle their automobile accident case. That can be alright if the lawyer is well versed in accident law and insurance matters. But, this type law changes like the shifting sands and has many nuances that the uninitiated may be dangerously unfamiliar with. Therefore, be aware of some principles of law that can be important. One is that the other driver may not be the only responsible party. This is true if someone else owns the car he was carelessly driving. The point is that your lawyer must know where to look for more than one policy that could pay benefits to you.

Another is that the fault situation doesn't have to be picture perfect for you to be substantially successful. It's not unusual for one driver to be much greater at fault than the other but for the other to also have some fault in causing the wreck. I'll give you an example. Let's say a driver pulled out immediately in front of you, but you were going a little over the speed limit. You couldn't have avoided the collision caused by his negligent driving even if you'd been driving within the posted speed limit, but your injuries wouldn't have been quite as bad. Let's also say the other driver was 90% at fault compared to your 10%. Many people would think they couldn't be successful in a case to get monetary compensation for their injuries, but the law says you are entitled to 90% of the value of your injuries, exactly the percentage of the other party's fault. If the stakes are high, get representation for whatever type legal case you have. You deserve it for your future.

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July 22, 2010

More About Dirty Tricks of the Insurance Industry

I recently discussed some of the dirty tricks the insurance industry uses to deny claims or to delay payments and told you I would later give examples. Today, I'll tell you about one of the techniques used by insurance companies to increase their bottom lines.

Consider this scenario. You are in your car running an errand. Suddenly, a pickup truck crosses the center line from the opposite direction and smashes into you head on. When you wake up from the coma days later, you have collapsed lungs, multiple broken bones, medical bills beyond imagination, and the news that your next painful months will be under the constant care of medical personnel. Now, you get the unexpected news from the insurance company that you had paid premiums to for years. It has denied coverage to you, because it claims the driver who hit you acted in a moment of deliberate road rage, so the accident was not really an accident at all. As such, it wasn't covered. You can't work, your bills pile up, and your insurance company has said "goodbye" to you. This is the true story of a 60-year-old woman who had a $2 million policy with one of the largest insurance companies in the U.S.

That insurance company, like others, is in the business of denying claims as a way to boost its bottom line profits. Her company even had an employee program that offered incentives, including $25 gift certificates and pizza parties, to adjusters who met low payment goals. It wasn't and isn't the only insurance company systematically denying claims without good reason. Some of the nations' largest companies, including the infamous AIG, hated within the legal world and so tarnished by its near economic failure and government bailout that it has changed its name to protect the guilty, have earned reputations as aggressive claims fighters in an attempt to boost their bottom lines. That's not what the policyholders pay them to do.

One company that I'll refer to as "Sadstate" Insurance gave adjusters who denied valid claims rewards like portable refrigerators. When units of another insurer lost money, its executives put in place new teams of adjusters to systematically reject thousands of valid claims. Following an earthquake in California, one company's officials forged signatures on waivers of earthquake coverage to avoid paying quake-related claims.

These travesties of justice are usually, but not always, caught by vigilant attorneys as was the case of the lady I mentioned whose insurance company claimed the wreck was deliberate, not accidental. She eventually prevailed but only after a legal battle that she shouldn't have had to engage in. Too many people are victims twice in a wreck, first, because of the fault of a careless driver and, then, a second time, from the dirty tricks of an insurance company.

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July 15, 2010

Insurance Companies Tricks of the Trade

The U.S. insurance industry has trillions of dollars in assets, enjoys average profits of over $30 billion a year, and pays its CEO's more than any other industry. But insurance companies still engage in dirty tricks and unethical behavior to boost their bottom lines even further.

The current economic turmoil affecting the insurance industry on Wall Street has only made the outlook bleaker for consumers living on Main Street in every U.S. city. Insurance companies are likely to demand huge rate hikes and refuse more claims than ever. Some of the most recognized insurance companies, the same ones that spend billions on advertising just like oil giant BP does in its industry, trying to earn your trust, have worked out methods to deny claims, delay payments, confuse consumers with incomprehensible language, and retroactively refuse anyone who may cost them money.

Some of the nation's largest insurance companies, like AIG that earned such a bad reputation when details of its inept business practices and government bailout became known, have denied valid claims in an attempt to boost their bottom lines. These companies have rewarded their employees who successfully denied claims, replaced employees who would not, and when all else failed, engaged in outright fraud to avoid paying claims.

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July 8, 2010

More About What You Need to Know About the New Health Insurance Law

After reading over two thousand pages of the new health insurance law and committee reports about it, in an earlier column I started telling you about some of the new law's benefits. If you are an elderly person, these benefits are important, maybe crucial. Let me tell you more about how this law that became effective in March will help you.

Some health care insurance companies have imposed yearly caps on the amount of medical or hospital care they will pay. Since that seems to be contrary to the idea that in exchange for a premium paid, an insurance company will accept the risk and pay for whatever care is needed, the new act in September will tightly restrict the refusal of payments by insurance carriers and will limit their restrictions to those defined by the U.S. Department of Health and Human Services. Better than that, effective in 2014, all plans are prohibited from setting those caps.

Next, the new act makes preventive care free. The idea is that if we can catch disease and illness early, the cost of treating the problems will be so much lower that the health insurance law will actually lower health care costs and save money for businesses, consumers, and the government. Hopefully, it will. Under the act, new plans are required to cover preventive services with absolutely no co-pays and deductibles. This section of the plan, too, will go into effect in September.

A lot of people who are uninsured now because of pre-existing conditions have hope, because in about a week, those people will have immediate access to insurance through a temporary, high risk pool. This law helps young people, too. Think about those who aren't insured by an employment policy because they are still in school, or they can't find a job because of a weak economy. Under old concepts, they might have been covered until age 21, but under this law, they will have medical insurance under their parents' policies until they are 26. That is if the parents agree that they will be covered.

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