Insurance Dispute Lawyer Blog

How Insurance Companies Could Defraud You

Published on: November 14, 2008 | By Berniard Law Firm

Insurance fraud is something everyone is aware of and leads to significantly higher premiums for anyone looking for protection. What the insurance companies do not talk about, though, is the very insurance fraud that goes on within the industry itself. While companies may drag their feet or act in bad faith in delaying payments or sending inspectors to the homes of policy owners, there are some very serious actions that have gone on that require policy holders to remain vigilant in their claims.

In a case relating to the 1994 Northridge earthquake in California, State Farm agents, according to the testimony of one of the company’s former employees, tried to avoid paying insurance claims to victims through forged signatures and altering documents to make it appear earthquake damage had been declined by policyholders. An investigation by a tv station in San Francisco in 1997 showed the company had also gone so far as to delay inspections and lower the value of claims of those individuals who took action against the company because of these delays. These acts of explicit fraud and malice by State Farm serve as an example of how policy holders must remain ever vigilant when it comes to their policies and insurance protection especially as they can happen anywhere.

Hitting closer to home, on May 2 of 2003, a Metairie insurance agent was shut down for forgery and misappropriation of insurance premiums, the third in four days. On June 27, 2005, another agent from Lafayette pled guilty to theft after pocketing premiums on insurance payments rather than sending them to the companies. These instances prove how important it is to make sure with the company you are buying insurance from that payments are received and coverage is verified.

These aforementioned examples of fraud are neither the exception nor the rule, but, instead, demonstrate why insurance policy holders in the Gulf Shore and elsewhere must remain ever vigilant on their claims of damages with insurance companies. Keep close records and copies of all of your insurance information and all documentation and pictures you have of the damage you are making a claim to your insurance company for.

How Texas’ Personal Injury Protection Protects You

Published on: November 10, 2008 | By Berniard Law Firm

Personal Injury Protection (PIP) automobile coverage in the state of Texas is a common insurance agreement in which the carrier will pay benefits to the policy holder because of “bodily injury resulting from a motor vehicle accident and sustained by a covered person.” Thus, helping someone financially who has been in a car accident that causes someone to be hurt is the general idea behind PIP benefits. Accidents have been strictly defined to be only those incidences directly relating to injuries coming as a result of the use of a motor vehicle. Those covered include the policy holder and any family member who was in or was struck by the vehicle.

The benefits entitled to an injured individual include reasonable expenses incurred for necessary medical and funeral services. PIP also includes the replacement of 80% of income lost during the period of disability up to the policy limits. PIP can also include, for those unemployed, expenses incurred for obtaining services that the covered person would have performed had they not been injured.

As a whole, PIP benefits relating to car accidents are pretty clear and supportive of policy holders. There are very few exclusions to PIP coverage except to remove from protection those accidents that are not related to driving a motor vehicle, i.e. breaking your ankle getting out of the car.

Insurance Companies Have To Follow The Rules Too!

Published on: November 9, 2008 | By Berniard Law Firm

The recent series of storms to come through the Gulf region have caught even some of the most seasoned residents off-guard when it comes to making insurance claims. In the wake of these storms, Texas residents statewide have encountered a wide variety of problems when making their claims. It’s important to understand the state laws that fall into play when making your damage claim in order to make sure you get everything entitled to you from your insurance company.

First, under Texas law, insurance companies normally have 15 days to begin their investigations to a policyholder’s damages claim. However, in the event of a natural disaster like a hurricane, Texas’ insurance department can extend this deadline to 30 days. While investigations may take as long as the insurance company sees fit, the company has 15 days to make a decision regarding the claim (30 days in the event of a natural disaster). In the events of an accepted claim, payment is to be made within five days.

When making your claim, make sure to maintain a journal or diary of dates related to what you send your insurance company. Keep a copy of every correspondence for your records and make sure to follow up quickly with any information requests the insurance company may send you.

A Hurricane Checklist To Make Sure You’re Prepared

Published on: November 8, 2008 | By Berniard Law Firm

The people of the Gulf Coast are well aware that hurricanes of all different intensities come and go through the region every summer. A Hurricane Checklist for anyone, whether you live in Houston, Galveston or Corpus Christi, Texas residents should have a list of things they do in the event of a hurricane.

One of those things involves having your insurance policy in duplicate, with one copy in a secure location and another in hand. With this preparation, delays in your policy claim can be prevented. Another thing to keep near in the event of a storm is a disposable camera. Just as car owners like to keep one in their glove compartment in the event of an accident, having a disposable camera to take immediate pictures of your damage can be another way to get your claim in as soon as possible.

A third thing to do to prepare for an insurance claim in the event of a natural disaster is to annually inspect your insurance coverage and even speak with an agent to review what damage you are and are not protected by. Such a review and conversation can help you know exactly what you are covered for and help you become more familiar with the language and/or agent involved with your insurance plan.

With talks that Gustav insured damage could total from $4 to $10 billion dollars, insurance claims from the state of Texas will be numerous and complicated. With Hurricanes Ike and Dolly also causing damage in the state, there are a lot of people reaching out to their insurance companies for their home damage.

Tips On Post-Hurricane Recovery in the Gulf Coast

Published on: November 7, 2008 | By Berniard Law Firm

The extreme damage incurred by the Galveston area is only now being comprehended over two months after Hurricane Ike. Recovery efforts are underway but the immediate steps to be undertaken in the event of damage to your home are crucial and need to be handled with care. If you live in the Gulf Coast area and have to deal with a damaging tropical storm or hurricane, whether you are in Corpus Christi or Lafayette, there are a series of things you must do in the aftermath. Here are some hurricane recovery tips:

In the event of a hurricane or extreme damage to your home, do not risk electrocution. Check electronic equipment for water damage and watch for damaged power lines. Open all of your home’s doors and windows to let air in and ventilate the area. Use bottled water and throw away any food and condiments that may have gone bad in the refrigerator if the power went out for an extended period of time.

When it comes to damage to your home and property, only make temporary fixes that will later be fixed using your insurance settlement. Doing so will allow the insurance company’s inspector to see the full extent of the damage and help you with your overall claim. After a storm, contact your insurance agent as soon as possible, photograph damage and keep all receipts and detailed records of your costs. FEMA assistance can be received by calling 1-800-621-FEMA (3362) or by going to www.FEMA.gov.

The Texas Department of Insurance’s Tips on Storm Recovery

Published on: November 6, 2008 | By Berniard Law Firm

The Texas Department of Insurance (TDI) has created a series of tips for homeowners in the state looking to make a claim after the recent series of storms in the Gulf. While each storm may lead to significantly different issues, there are several things the state recommends with any claim:

1. Develop an organized and itemized list of the property damaged and visually record the damage if it is possible. This will help speed the claims process.
2. Attempt to make appropriate temporary fixes and repairs so as to keep your property and home from any further harm from the elements. Make only temporary fixes until the insurance company’s claims adjusters can assess the damage. Record all expenses incurred by repairs through receipts and other means.
3. Be on the property or at home when the insurance company visits to assess the damages being claimed. Having a contractor available during the inspection or when you receive the adjuster’s claim is also encouraged.

Following these guidelines will help make sure that you are sufficiently prepared in the event of storm damage. If you have problems with your insurance company, call TDI’s Consumer Help Line toll-free at 1-800-252-3439.

Annual Car Insurance Reviews Could Save You Plenty

Published on: November 5, 2008 | By Berniard Law Firm

Annually, it is recommended for anyone living in the Gulf Coast area to do a full inspection of their insurance coverage. While people are often meticulous with their car insurance and its coverage, home owners insurance can be a confusing and daunting set of documents to review and even understand. However, a solid review of your plan’s limits and extents will help you be prepared should damage come to your home.

Periodically reviewing your coverage helps guarantee you have the protection you need in the right areas. These reviews can coincide with the renewal of your insurance or at the time in which you purchase significant enhancements or items for your home that change its value. Reviewing can be as simple as re-reading the literature provided that summarizes your coverage but can, and should, also include a call to your insurance agent. Simply asking your agent to go over your homeowners, damage protection and other insurance provisions can help you get a concise and clear idea of what your insurance will protect you from.

Feel free to have a frank and honest conversation with your agent about if the coverage on your home is adequate or if it needs to be adjusted based upon the value of those things being protected. Such a conversation keeps you from finding out that your recent boat purchase or the deck improvement that increased your home’s value are not covered.

By reviewing your insurance coverage and talking with an agent, disputes that may arise should damage occur that you must make a claim on may be avoided.

Don’t Be Left Out To Dry On Wind vs. Flood Damage Disputes

Published on: November 4, 2008 | By Berniard Law Firm

Dealing with hurricane and other forms of severe weather damage can be a truly confusing and stressful time for homeowners. Figuring out the best contractor to fix the work, temporary fixes for the damage, however severe, and moving on with life are all dilemmas people have to deal with in the face of such disasters. What makes things worse, however, is when insurance companies make it difficult to make a claim.

One of the most common ways in which insurance companies deny claims for righteous hurricane or storm damage is blaming the damage on wind or flooding, depending on coverage. In numerous cases post-Katrina insurance companies like Allstate and State Farm denied a claim of wind damage relief because the true damage was caused by flooding. The courts, though, have found that any flooding that comes as a result of damage caused by wind is thereby covered under a wind damage claim. That is to say, for example, if wind damage caves in your roof, all of the rain and water damage that results from the broken roof is covered.

The courts have further held that concurrent causation clauses like State Farm’s are capable of being knocked down because of the close proximity of damages. The overriding principle for homeowners to keep in mind is that if they can prove the wind damaged something, coverage by the homeowners wind policy should cover the damage, even if the flood came through afterwards and destroyed the home. The difficulty comes in to cases such as this, though, in the expert testimony and the proof claimants must provide that the wind came first.

When dealing with your denied claim in which your insurance provider is denying coverage on the basis of wind vs. flood causation, it is important to have the experts necessary to prove your case. The Berniard Law Firm knows all of the best experts to refute the insurance company’s claims that the flood came first. Excellent legal council, coupled with the experts that can tell the court exactly why you deserve your claim, can be the difference between rebuilding your life with help or rebuilding from scratch.

Get the Car Insurance Claim You Are Owed!

Published on: November 3, 2008 | By Berniard Law Firm

The loss of one’s vehicle to any sort of calamity is a stressful and difficult event for anyone. When this loss occurs amidst a natural disaster, such a loss can feel completely overwhelming. What can make it even worse is when the insurance company drags their feet in paying you the very money you deserve. The law, however, protects the people from insurance companies dragging their feet and does so with strict penalties for such delays.

In the event of the inaction of an insurer that leads to deprivation of the use of a personal vehicle for more than five working days (excluding weekends and holidays), the insured party is entitled to any legally reasonable expenses that resulted during the entire period of time the claimant is without the vehicle. If the insurance company fails to pay this within 30 days of a claim that the insured is without the use of the vehicle, and the failure is deemed arbitrary, capricious or without probably cause, an additional penalty not to exceed 10 percent of reasonable expenses, or $1000, whichever is greater, will be tacked onto the claim with attorneys fees.

What this means is that, with a speedy claim and consistent effort to stay in line with deadlines and paperwork, the law protects Louisiana citizens from becoming overwhelmed in the event of a catastrophe.

How to Avoid Insurance Company Bullying

Published on: November 2, 2008 | By Berniard Law Firm

When working on an insurance claim for damages incurred for any set of reasons, it is important for Louisiana citizens to remember that while the insurance companies might not respect them, the law does. Louisiana law includes various different provisions to prevent insurers from taking advantage of policy holders and it is important for people to know their rights.

Louisiana law mandates a good faith effort on the part of insurance companies to their policy holders. This includes adjusting claims fairly, promptly and to make a reasonable effort to make settlements with the claimant or insured. Insurance companies violate this law when they

1. Misrepresent policy provisions or facts relating to a holder’s coverage.
2. Take longer than 30 days to pay a settlement after a written agreement is met.
3. Attempt to settle or deny coverage to a claim that was modified without knowledge or consent by the insured.
4. Lie or mislead a claimant as to the prescriptive period of a claim.
5. Fail to pay any claim due to an insurance holder within 60 days after they receive a satisfactory proof of loss from the holder when failing to do so is arbitrary or without probable cause.

If an insurance company is held liable for any of these violations, a policy holder may be rewarded financial damages of significant value. This money is in addition to the settlement already made.