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What To Do When An Insurance Company Breaches Its Contract

Maui Reyes

With so much paperwork given to you by insurance companies, most people tend to overlook exactly what their contracts are about.

It is part of insurance law that any ambiguity or uncertainty in the choice of wording in a contract will be resolved in favor of the policy holder, and not the insurance company. This often works in favor of the policyholder when it comes to pointing fingers in court, but not all the time.

Most policyholders tend to have their own interpretation of the contract. Unfortunately, the judge doesn’t care about the policyholder’s understanding of the wording. In court, “plain meaning” is what the judge looks at. “Plain meaning” is how an ordinary citizen or common reader understands the text, and not how the policyholder, insurance company, or lawyer interprets it.

While courts do not necessarily interpret a contract at the expense of the policyholder experiencing a loss, it does not give leeway for “misunderstandings” of plain text by the policyholder.

Which is why contracts must be free of any ambiguities for both the insurance company and the policyholder. Whenever exclusions or limitations are stated, they must be stated very clearly. Oftentimes, insurance companies fail to fully explain these limitations to their clients, resulting in them successfully denying certain coverage when there is a loss. It is the insurer’s policy to explain the contract to the client, especially if he is not aware of his rights or if he does not know if he is getting what is due fully his. However, the insurer is not required to tell him the adequacy of the insurance amount he selected. Keep in mind that when a contract contains provisions that are in favor of the company, the court will deem this unconscionable, and may refuse to enforce such provision.

Keep substantial evidence at hand. In such cases where a client is led to believe an advertisement or promotion of an insurance company that turns out to be false, depending on the state, legal protection can be provided for you.

When you are able to successfully prove that your insurance company has breached a contract, you can recover damages for consequential losses, loss of use of the insurance proceeds, general damages, attorneys' fees, and, in cases of egregious and misconduct, punitive damages.

Whatever happens, be sure to act fast. Insurance companies are always a step ahead of you in the legal department. Depending on the state, the statute limitation for a case like this is 2 years. In California, you are only given 1 year.

About The Author


Maui Reyes has written various articles of different topics. She has a clever writing skills that is good for product reviews,discussion of new technological innovations, health problems, legality issues and many more. Another factor that made her land into this job is her flexibility in her writing, she can write just about everything under the sun.

For additional legal information and inquiries about the article log on to http://www.attorneyservicesetc.com
carmelo@attorneyservicesetc.com

High Deductible Health Insurance Plans For Individuals and Families

 by: Michael Ertel

Do you pay more attention to your car than your body? You change your oil every 3000 to 4000 miles. You have your tires rotated every other oil change. Your air filter and brake pads are changed at the appropriate intervals.

Now, what about your body? You follow the recommended AMA guidelines for routine check ups and other healthcare services. You pay special attention to make sure you eat a balanced diet and always take the time to get enough exercise. The reality is many Americans pay more attention to the maintenance of their car than they do their body.

From an insurance perspective, your automobile insurance company has a certain expectation that you will take reasonable care of your car. Things such as the routine maintenance of brakes and making sure your turning signals work properly are expected by your insurance company. Basic common sense says that proper automobile maintenance reduces traffic accidents and saves both you and your insurance company money.

Health insurance consumers can benefit by taking a similar approach to taking care of their body. For the average American, regular exercise, routine check ups and following your doctor’s advice will reduce your healthcare costs in the long run. It is really very simple. By doing the things necessary to stay healthy, you will need to seek medical care less frequently.

Even with a commitment to stay healthy, you will still need health insurance coverage to take care of the unexpected and sometimes unavoidable catastrophic situations. However, instead of paying the insurance company for a $250 deductible, many individuals would benefit by purchasing a high deductible health insurance plan. Depending on the specific situation, it is not uncommon for individuals and families to save up to 25% on premiums with a high deductible plan. Health Savings Accounts (HSAs) can then be set up to coordinate with the high deductible plan. Approaching health care and health insurance wisely will benefit both your body and pocketbook.

About The Author

Michael Ertel is the founder of http://www.MedicalInsuranceNow.com which is a website that assists individuals and small business owners by providing side by side comparisons of health insurance alternatives.

MErtel@medicalinsurancenow.com

 

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Aarp Health Insurance News Releases:

AARP joins suit against Caterpillar (Belleville News-Democrat)
The AARP has joined a lawsuit against Peoria-based Caterpillar Inc. filed by retirees who claim the company has reneged on an obligation to provide them free health care coverage for life.

AARP signs on to retirees' suit against Caterpillar (Quad-City Times)
PEORIA, Ill. (AP) — The AARP has joined a lawsuit against Peoria-based Caterpillar Inc. filed by retirees who claim the company has reneged on an obligation to provide them free health care coverage for life.

AARP wants drug companies to disclose gifts to doctors (Legislative Gazette)
The AARP was in Albany last week to draw attention to a growing problem in New York's health care system — the rising cost of prescription drugs.

AARP joins retiree lawsuit against Cat (Peoria Journal Star)
Complete local and regional news, local business directory including restaurants, local classifieds and Central Illinois information.

Vermont health care reform becomes law (The Burlington Free Press)
RUTLAND -- Republicans, Democrats, medical professionals and consumer advocates gathered Thursday at Rutland Regional Medical Center to celebrate the signing of a pair of health care reform bills.

Drug retirees adjusting to health-insurance costs (The Kalamazoo Gazette)
Some of the 5,600 Upjohn-Pfizer retirees who were stunned last year by dramatic hikes in health-insurance premiums say they've adjusted their lifestyles downward to meet coverage costs.

New York Needs Relief From Rx Costs; State Legislative Leaders, Experts Focuson Rx Affordability Legislation at AARP (U.S. Newswire via Yahoo! News)
Drug companies spending billions of dollars on gifts to doctors and soaring drug costs were hot topics today as state legislative leaders and national experts on prescription drug issues joined with AARP leaders for an Rx affordability forum in Albany. The AARP event focused on legislative solutions to New York's growing prescription drug problems.

Health Calendar (Quad-City Times)
Hy-Vee Diabetes Tours . Take an aisle-by-aisle tour to learn how to better control blood sugar levels, 10 a.m. Friday, May 26, Hy-Vee, 1823 E. Kimberly Road, Davenport.

NUMBERS & WEB SITES (New Orleans Times-Picayune)
-- The Southeast Louisiana Chapter is offering training and preparation classes for the upcoming hurricane season. Visit www.arcno.org or call (800) 229-8191.

AARP Rx Forum to Focus on Affordability Legislation in NY (U.S. Newswire via Yahoo! News)
> Soaring drug costs, drug companies spending billions of dollars in gifts to doctors, and the need for relief will be the focus of an AARP forum this Wednesday in Albany. State legislative leaders, national experts and AARP leadership will discuss high drug costs in New York State, the impact on all New Yorkers, and legislative solutions to the problems.

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