Insurance Law contains: 247 Articles, 181 FAQs, 31 Attorney Interviews
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Insurance Law encompasses auto insurance, business insurance, disability and health insurance, life insurance, viaticals, and more. If you have questions about an insurance policy, need advice about a claim, or have another insurance question, find the answers and information you need here in the Insurance Law section of FreeAdvice.
The insurance business is governed by thousands of pages of insurance laws, regulations and rules that were originally intended to protect consumers and regulate the conduct of insurance companies and their agents and brokers. The rules lay down standards that the insurer and its agents must follow during the course of the sales process, specify certain provisions insurance policies must provide, restrict how insurance companies decide who to cover (the insurance underwriting process) and regulate the rates the insurance company can charge. The insurance laws and rules also cover how quickly claims must be paid, and what the insurance company and those who work for it, must do – and may not do -- when an insurance claim arises.
Insurance law can be complicated. In addition to the major types of insurance most consumers are aware of -- auto insurance, health insurance, homeowners insurance, life insurance, and disability insurance -- there are dozens of additional types of insurance for individuals and businesses, like commercial lines insurance and workers’ compensation insurance, among others. The nature of insurance laws and regulations often varies according to certain factors. The type of insurance, whether you buy the policy yourself or as part of a group, by the state, by the type of insurance company that provides the coverage, and by whether you are a policyholder, an additional insured, or someone injured by one of the insurance company’s insureds (a third party claimant.)
Further complicating matters is that there are thousands of insurance companies, hundreds of thousands of insurance agents and insurance brokers, and countless insurance adjusters, underwriters and insurance company administrators, claims examiners and staff. Too often insurance companies don’t play by the rules and laws, and there are a few insurance companies that seem to be evil, sometimes equally so whether dealing with their own policyholders or third party claimants.
What to Do if You’ve Experienced a Wrongfully Denied Claim or Other Insurance Company Abuses
The first step in protecting yourself is to know what actions to take if you’re being abused by an insurance company, or by one of its agents, claims examiners or adjusters. Insurance companies are powerful, but they aren’t above the law. There are three main ways to deal with your insurance company when you feel you have been treated unfairly.
One approach is to try to resolve the claim with your insurance company to come to a resolution. Usually, denied claims can be appealed, although it isn’t clear how many of these appeals end up with a different outcome. Depending on the circumstances, it is sometimes beneficial to initiate two or even all of these remedies.
A second way to deal with unjust treatment by an insurance company is to report the abuse to the state insurance regulator in your state. Often called the Department of Insurance, the state’s insurance regulator is supposed to enforce the state insurance laws and regulations code through administrative procedures. However, many insurance regulators are underfunded, understaffed and overburdened. As a result, depending on the state, relying on the insurance department to help may be futile.
The third approach is to retain an attorney to deal with and, if necessary, sue your insurance company. While it is always possible to try to sue the insurance company without an attorney, unless you are an expert in insurance, or the claim is very small so that you can handle it in a small claims court, insurance companies are experts in defending claims and are likely to put you through the legal wringer if you try to handle any meaningful case yourself.
If the insurance company has not met its obligations to you under the insurance policy the action is for breach of contract. In a breach of contract claim you are seeking the benefits that you are entitled to under the insurance policy. This might mean forcing a health insurance company to pay for a procedure that they wrongly claimed was experimental, or paying under your auto insurance policy’s uninsured motorist’s coverage if the driver who injured you had no coverage.
If an insurance company has acted in bad faith while denying your claim, you also may have a separate claim for insurance bad faith. That would enable you to recover additional damages beyond what the policy promised and the insurance company should have paid, including any additional damages you suffered because of the delay in payment, plus punitive damages, which are designed to both penalize the insurance company and deter the company from treating insurance consumers improperly in the future.
To learn more about different types of insurance policies and the laws and regulations that apply to the insurance industry, click the links on this page to find lawyer-prepared articles and answers to frequently asked questions on various Insurance Law topics. If you are interested in buying insurance, visit FreeAdvice Insurance.