Posts Tagged ‘ Insurance ’

What’s the “Bad” in Bad Faith Insurance?

September 7th, 2010. By Kristine B

You’ve probably seen the commercials on tv: an actor—say Dennis Haysbert—walks around talking about how “his” insurance company (that would be Allstate) is his best friend…how it has his back in a bad situation…how it has bent over backwards to help him in his time of need…and, damn if he doesn’t sound so sincere! Or you’ve seen Flo–the Progressive Insurance girl–making it sound like no way no how would Progressive ever—EVER!—give you a lousy rate. No siree—Flo ensures us that buying insurance is as easy as ordering a Whopper with cheese, hold the pickles—thanks.

But, when it comes time to file an actual claim—when a real person needs real help from a real insurance company, all of a sudden it seems like there are a million reasons why the company won’t pay out a claim. Sometimes, that leads to claims of bad faith insurance—today’s Pleading Ignorance topic.

Before we get to that, though, the obligatory “not every denied claim is a legitimate claim” spiel. It’s true that insurance companies have to protect themselves from fraudsters and people out to make a quick buck off an accident. There are people who see an accident—real or faked—as a way to make easy money. This, of course, puts the honest people at a disadvantage. Why? Because they’re dealing with insurance companies that a) want to make as much profit as possible and b) have to unfortunately protect themselves from fraudsters who see the insurance companies as personal ATM’s.

The mix of profitability and self-protection can lead to claims of bad faith insurance.

So, what is bad faith insurance? You’ve probably heard of it before, because the companies that are accused of practicing it are often large insurance corporations—so it gets airtime in the news. Bad faith insurance occurs when an insurance company denies legitimate claims for illegitimate reasons.

Here’s the thing: When you buy an insurance policy to protect yourself or your family and you pay into it faithfully, with the full expectation that if you should ever need it, the policy will cover you, the insurance companies are required, by law, to pay out your legitimate claims.

Of course, it all looks good on paper—just like that insurance policy!—but when it comes down to it, some insurance companies use all sorts of tactics to avoid paying claims.

They might stall on the claim by forcing you to send in excessive amounts of paperwork—or they may claim to have found “mistakes” in the paperwork you’ve sent in. By stalling, they may push back the time your claim is received so that your claim is no longer valid. They might retroactively cancel your insurance policy—in effect waiting until you make a claim then deciding you shouldn’t have had the policy to begin with. They might find their own medical examiners who overrule your own doctor’s diagnosis. They might reclassify your illness or your claim and state that you should be able to work when you really cannot. Or they may classify a seemingly standard lab test as outpatient surgery requiring precertification that, of course, you did not get. The list of possibilities is endless.

Some insurance companies might target specific claims for denial; these claims might include anyone who claims Fibromyalgia or Chronic Fatigue Syndrome. People making those claims might automatically have their claims denied or may be required to send in additional paperwork to support their claim.

The bottom line is that “bad faith insurance” occurs any time that a legitmate claim that you’ve paid insurance premiums to be covered for is denied or delayed without sound reason. And, if you’ve found yourself in that position and have gone through the proper channels of contacting the insurance company and requesting that your claim be reprocessed or you’ve filed an appeal with the insurer to no avail, you may want to get some legal help.

Tags: Bad Faith Insurance, Denied Insurance, Insurance, Pleading Ignorance
Posted in Insurance, Pleading Ignorance | 2 Comments »

Coakley Loses, but Wins Big for MA Motorcycle Owners

January 21st, 2010. By AbiK

Git your motor runnin’…The Democratic loss in Massachusetts was (is still) all over the news—but one bit of news about MA Attorney General Martha Coakley was not so prevalent: her settlement to the tune of $11.1 million with motorcycle insurers who overcharged riders.

It seems that a few motorcycle insurers—Safety Insurance Company, Liberty Mutual Insurance Company, and Quincy Mutual Fire Insurance Company—were allegedly basing their premiums for motorcycle insurance on incorrect motorcycle values.

Now, if you’ve ever had your heart set on a Harley, and had to wait to save up the money for that Fat Boy or Low Rider (personally, I’d be going for a Sportster 883 or 1200), the last thing you want to do is cough up even more money on a high insurance premium. But you’re typically at the mercy of the insurance company—you need insurance to ride, and motorcycle accidents do happen.

Upon an investigation that, according to insurancenewsnet.com, began over a year ago, it came to light that the insurance companies were basing their collision and comprehensive premiums not on the current book values of the bikes being insured, but on values that were out-of-date and inflated.

An example given was for a 1999 Harley Davidson Road King Classic (which nowadays will set you back about Read the rest of this entry »

Tags: Insurance, Liberty Mutual, Massachusetts, Motorcycles, Quincy Mutual, Safety Insurance
Posted in Settlement | 3 Comments »

$150M Zurich Insurer Settlement…by the numbers

September 11th, 2009. By AbiK

Here’s the down and dirty on the insurer price fixing class action settlement imposed on Zurich Financial Services and Arthur J. Gallagher & Co.—the settlement was upheld on Tuesday after going through an appeal process stemming from the original 2006 settlement ruling. The upheld settlement was reported on in the NJ Law Journal.

[By the way, if you want to read about Zurich’s history with price fixing, see previous Zurich articles here]

Settlement Amount:

$150 million, plus $29.9 million in legal fees and costs, paid by the insurance companies as follows:

$122 million to be paid by Zurich Financial Services

$28 million to be paid by Gallagher & Co.

$29.9 million to be paid separately by Zurich to plaintiffs’ lawyers

Who Gets the Settlement Money:

3.79 million potential class members–maybe more, according to estimates

How’s the Settlement Money’s Divided:

51.7% goes to Zurich policyholders who bought excess casualty insurance from 2001 to 2004

33.9% to policyholders who bought other lines of insurance or excess policies at other times

9% to non-policyholders who were affected by the alleged wrongdoing

States party to the Settlement Agreement:

10…California, Florida, Hawaii, Maryland, Massachusetts, Oregon, Pennsylvania, Texas, Virginia, West Virginia

Tags: Gallagher, Insurance, Zurich
Posted in Settlement | 3 Comments »