Golden Rule Health Insurance
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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
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International Travel and Health Insurance
David M. Schmader
Embarking on Your Dream Vacation
Are your Plans Complete?
Your bags are packed, passport and papers in order and you couldn’t be in a
higher state of excitement preparing for travel to that wonderful, exotic location.
This is the vacation you have planned it seems forever. As you sit on the plane,
you and your partner discuss for the hundredth time the scuba diving you will
do, the awesome rock climbing and hikes into the rain forest. Everything is
perfect!
Life seldom gets better than this.
Despite all the excitement of travel, Americans do have some concerns.
According to a survey by the Chubb Group, more than 70% of Americans surveyed
said their greatest concern when traveling is suffering a medical emergency...more
than double the fear of being mugged (30.7%), three times the fear of being
injured in a terrorist attack (23.4%).
What happens if a medical emergency arises when traveling overseas?
Many people assume that while they are out of the U.S. or Canada they will be
covered by their standard medical plan. However, most traditional health insurance
plans are not designed for international travel.
According to the U.S. Department of Commerce, approximately 27 million travelers
board U.S. airlines for overseas destinations and almost 26 million foreign
travelers come to the U.S. each year. However, many are not prepared for a medical
emergency abroad.
Most traditional health insurance plans would not cover an unexpected illness
or injury during international travel. But travelers with international medical
insurance would have protection for scenarios ranging from a local ambulance
trip to an emergency evacuation for care at the nearest qualified medical facility.
Some even offer repatriation flights out of the country where the traveler is
located back to the US.
Available plans can cover individuals or groups for specific periods of time
abroad and can be in effect should they be stationed abroad for an extended
period of time. There are policies for corporations to insure their personnel,
plans to cover missionaries who are on an outreach program and for those participating
in extreme sports. International travel medical insurance should be considered
for anyone traveling or living abroad.
©David M. Schmader, Solon, Ohio January, 2005
www.brownschmader.com
About the Author
David Schmader is an independent broker agent located in the Cleveland Ohio
suburb of Solon, Ohio. With over 25 years of corporate finance experience he
specializes in serving the individual, professional and small business markets.
Golden Rule Health Insurance
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