The fact of the matter is that individuals need insurance for a variety of circumstances. From protecting our families to protecting our property from the unpredictability of the world, insurance is essential.
But what happens when an insurance company doesn’t follow through with its end of an agreement? This is where bad faith insurance lawyers step in to aid you where the insurance companies do not.
One of the more common occurrences of bad faith is when an insurance company refuses to uphold its “duty to defend.” Let’s explore what this means and how it affects policyholders.
The “duty to defend” is a provision included in your insurance policy that outlines the job of the insurance company to defend you against particular types of legal action.
Of course, it’s important to always review your policy and understand what falls under your scope of coverage. However, if a lawsuit is brought against you that lands in this scope, the company is required to deal with the claim.
Here are some examples where this may be the case:
However, there are instances where your insurer is not required to provide legal counsel, which should be stated in your policy. For example, if you were inebriated when rear-ending someone, the insurance company may refuse to help because you intentionally put yourself under bad circumstances.
These different factors are all reasons why it’s important to fully understand the “duty to defend” provision of your policy. Seek out the help of Millin and Millin if you get a notice of “insurance claim denied” instead of legal aid. Millin and Millin’s highly knowledgeable bad faith insurance lawyers are ready to get you the legal help you need!
Ask for a FREE Case Evaluation
There’s no denying that insurance coverage and insurance claims can be frustratingly complex and confusing. Unfortunately, this is especially true of cases in which a person needs to sue their own insurer.
Even seemingly simple questions, like where to file your suit, can lead to complicated and unclear answers.
Still, if you had an insurance claim denied for a loss that should have been covered by your policy, then you may need to sue in order to get the compensation you are owed. Today, your compassionate McAllen bad faith insurance attorneys at Millin & Millin will help you determine if, how, and where you need to file a suit against your insurance agency.
Federal vs. State Court
Deciding where to file your bad faith insurance lawsuit can be quite complicated. First of all, you will need to choose whether to file in state or federal court. While there are many differences between filing in these venues, one key difference is the relative restriction on discovery in federal court. In a state court, an insurance company may be forced to reveal more about their claim file relative to a federal court.
It’s worth noting that state and federal procedures often contradict each other, meaning that picking between the two will likely depend on the specifics of your case and the evidence available.
Determining Jurisdiction
You must file your suit in a court that has jurisdiction over your insurance company. Given the massive physical network that comprises most major insurers, finding out which court has jurisdiction may not be simple. In order to show that the court you plan to file in has jurisdiction over your insurer, you will need to prove either general personal jurisdiction or specific personal jurisdiction.
‘Personal jurisdiction’ alone just means the power to cause a person to appear in court and the power to pass judgement on that individual. This differs from ‘subject matter jurisdiction’ which is based on a court’s ability to assess certain types of cases, but not their ability to pass judgement on the parties involved in those cases.
If a court has general personal jurisdiction over a party, that means that the party has a “home” within the court’s area. For human individuals, this literally means their home. However, for businesses, that “home” is located at the business’ principal place of business in the state where it was incorporated. This is usually the same as the business’ headquarters.
Next, if a court has specific personal jurisdiction over an individual, that means that the individual committed the offense of which they are accused within the court’s area. This means that if a person who lives in Georgia assaults you in Texas, you can sue in either Georgia or Texas.
In regards to insurance companies, you may be able to file a bad faith insurance suit in the state where the “breach” actually happened, a.k.a. the state where the insured person or property is. Regardless, you will have to prove that the offense occurred within the state, a process which can actually differ from state to state.
Filing a McAllen Bad Faith Insurance Claim With the Help of Millin & Millin
With that being said, finding out where to file a bad faith insurance lawsuit isn’t a straightforward process. Determining which court will be most advantageous to your case requires knowledge of all of the possible venues and the relative strengths of each.
An experienced McAllen bad faith insurance attorney at Millin & Millin can help you fight for your rights to coverage and compensation.
If you feel your insurance company has wrongfully denied your claim, reach out to the McAllen bad faith insurance lawyers at Millin & Millin today for help determining the best path forward.
While insurance policies may vary widely in the kinds of losses they cover, the sorts of claims a person might make come in a few common forms. Whether you’ve been involved in a car accident or suffered a house fire, you may be able to file an insurance claim for the compensation you need.
Unfortunately, your insurance company may try to avoid paying what you are owed.
If you’ve been injured or suffered damage against insured property, our McAllen bad faith insurance lawyers at Millin & Millin can help you explore your options. If you’ve filed a claim only to have that insurance claim wrongfully denied, we can work to hold your insurance carrier accountable.
Today, we’ll list five of the most common types of insurance claims you should know about.
A first-party insurance claim is a general term meant to describe claims for many different types of damages. First-party claims are made by individuals under an insurance policy that they purchased directly from an insurance provider.
Essentially, these are claims that you make with your own insurance provider.
First-party claims can cover either personal injuries, illness, or damages of insured property. Successful claims can result in payouts or reimbursement. Insurance companies have to legally judge claims reasonably and in good faith against the coverage laid out in your insurance policy. If they fail to comply, you may need to file additional claims or a personal injury suit with the help of an insurance attorney.
Bad faith insurance claims can be made if there is a dispute regarding the coverage provided by the policy, if the policyholder feels they weren’t paid what they were owed, or if the insurance company failed to make payments in a timely manner. These claims may also be made if the policyholder feels they were misled by their insurance provider at the time of the sale of the policy, whether regarding the amount of coverage available or the cost of coverage.
If your initial insurance claim was denied, especially if you feel the reasons for said denial were insufficiently explained, you may need to make a bad faith insurance claim with the help of a McAllen insurance attorney to get the coverage you rightfully deserve.
Given the high cost of homes and home repairs, it should be no surprise that some of the most common sorts of insurance claims are those made against homeowners insurance. Homeowners purchase insurance policies with the intent of protecting themselves from the financial losses caused by damage to their homes.
Damages that may be covered include:
○ Wildfire
○ Hurricanes
○ Tornadoes
○ Wind
○ Robbery
○ Mold damage
○ Vandalism
○ Land contamination
○ Appliance failure damages
While many homeowners claims are first-party claims, you may need to file a claim with someone else’s homeowners insurance if you are injured while visiting their home.
In Texas, drivers are required to pay for the damages resulting from any accidents that they cause. For most drivers, this means carrying proof of insurance, specifically, liability insurance. Liability insurance pays for damages that you cause against another driver’s vehicle. This coverage also includes payment for any injuries or wrongful deaths caused by your actions or carelessness while driving.
For damage to your own vehicle and personal injuries caused by your actions, you will most likely need to make a claim under your collision coverage and personal injury protection, or PIP coverage. These types of coverage are not required under Texas law and may not be included in your basic policy.
Granted, car insurance will also come into play if you’re involved in a car accident caused by someone else. In that case, you will typically need to file a claim with the at-fault party’s insurance provider.
The final major type of insurance claim is a health insurance claim. Health insurers function by charging policyholders a monthly fee in exchange for guaranteeing certain coverage in case of a medical issue.
These claims are usually filed by your healthcare provider, but you may need to make a claim yourself if your insurance provider is attempting to deny your coverage. Claims for treatment may be rejected for many reasons, from out-of-network treatment to treatment for injuries that a carrier argues were caused by dangerous behavior on the part of the injured person.
Insurance companies, like all private companies, are in the business of making money. Because of this, they may attempt to pay you less than what you are owed or deny your claims altogether.
If you’ve been injured or suffered damages covered by your insurance policy, contact the insurance attorneys at Millin & Millin, PLLC, to protect your rights to compensation.
Request Your FREE Case Evaluation
Life insurance is a valuable resource for anyone, as it pays out a lump sum to family and/or other dependents in the event you pass away during the term of the policy. A life insurance policy affords the peace of mind that loved ones will be financially protected in the event of your death, and that the money provided will be able to pay for expenses such as a mortgage, outstanding debts, living costs, and other expenditures.
Being aware of your life insurance policy and its coverage is important, especially right now with a global pandemic leading to much loss of life. The insurance lawyers of Millin & Millin want to provide you with some critical information that can help you to better understand life insurance at this point in time.
While COVID-19 has presented challenges across industries, the life insurance sector has largely been unaffected. Life insurers are not pulling out of the market, and as premiums remain steady, industry watchers are seeing COVID-related claims already being paid out, less than one year from the outset of the pandemic.
In most instances, traditional life insurance policies, including whole and term life, cover COVID-19 related deaths. There are, however, exceptions where a policyholder may have their claim denied by their insurance provider.
Reasons claims are denied frequently include:
An inaccurate or incomplete application may result in claim denial for reasons including not disclosing travel plans, not providing truthful information regarding income or even failing to accurately provide information about your health, such as your weight.
In the event that a policyholder loses their life within the first two years of coverage, an insurer will closely examine the claim and thoroughly review the initial application. It is important to be truthful and transparent throughout the application process, and policyholders are encouraged to ask questions should they not understand aspects of the application.
Should a policy lapse as a result of non-payment, it's likely a beneficiary will not receive a payout if the policy isn’t reinstated prior to the policyholder’s death. While most companies extend a 30 or 31-day grace period for late premium payments, you will remain covered as long as your insurance provider is paid within the allotted time.
In the midst of the pandemic, insurers may extend this grace period, with some state regulators already making these extensions a requirement. Insurance companies are willing to work with policyholders, and if you’re experiencing financial difficulties in making payments, it’s important to reach out to your insurer to discuss your options to avoid a lapse in coverage.
In the event of an accident, accidental death and dismemberment insurance (AD&D) is another form of coverage that can provide a payout. However, if a person dies as a result of illness or disease, an AD&D policy will not be paid out. AD&D coverage is sometimes added to a standard life insurance policy as a rider, and in those instances, the primary policy will payout in the event of a COVID-19 related death.
It’s important to understand your insurance coverage and your rights.
In the unfortunate event that you should lose a loved one and have a viable insurance claim denied, the insurance lawyer of Millin & Millin can help to right the wrongs done against you. We have years of experience handling bad faith insurers and can make sure you get what is owed to you.
As we start spring, construction projects are likely to increase now that the winter months have come to an end. Unfortunately, spring is also the season of storms, so it is extremely important to have the right builder’s insurance set in place in preparation for a bad situation.
The purpose of construction insurance is to protect construction projects while they are taking place. So in the case of an incident that leads to damage, construction companies and project owners are protected against any potential financial losses.
The reliable bad faith insurance attorneys of Millin & Millin want to provide you in-depth information on what construction companies should know about Texas Builder’s Risk Insurance this spring season.
Each year, storms, fires, and other disasters rock Texas, causing billions of dollars worth of damage to buildings and houses, including those that are still under construction. In a region that is susceptible to unforgivable spring weather, there is no question that builder’s risk insurance is essential as the likelihood of being impacted by a spring storm is greater than in other areas.
If this type of damage isn’t covered by your traditional builder’s insurance, it could drastically postpone a project, or result in them failing, if the financial loss is large enough.
Builder’s risk insurance can offer protection for delays, market loss, faulty workmanship, and other indirect incidents that result in losses. While not all builder’s risk policies are identical, the vast majority cover all-risk basis. Basically, it’ll take care of all causes of loss except for those not mentioned in the policy.
Generally, builder’s risk insurance policies cover:
Coverage may be consolidated for the builder’s risk for extra costs that occur because of a construction delay. These construction costs include, but are not limited to:
It is worth noting that builder’s risk policies typically cover new construction expenses, meaning your insurance might just cover the recently renovated or fixed parts of the building if you’re working on an existing structure. The policy might only address the new construction costs’ value and dismiss any damages to the current structure.
While insurance companies hold the right to deny certain coverage outside of your policy, some will reject perfectly worthy claims. Bad faith insurance acts are used to convince you that your insurer’s rejection is within their rights. A common tactic used is to say that your filed claim isn’t part of your policy - even when it is.
Exclusions are losses that aren’t mentioned in your policy. Your insurance provider may declare that your damages are excluded from the policy to get out of covering them. They may intentionally misinterpret your claim so they can completely decline it.
In some cases, your insurance may state that the damages already existed, that you didn’t notice the damage as pre-existing, or they might even accuse you of insurance fraud.
Even if your claim may have been denied, you don’t have to give up on seeking coverage. If you think your insurance provider acted deceitfully, then you may be eligible to file a bad faith claim. An insurance company acts in bad faith when they fail to demonstrate their expected responsibility as an insurer. You may be able to file a claim against your insurance company and receive compensation for any losses you experienced because of the denial.
Insurance law is very complicated, so it is imperative to seek the right representation and resources to challenge an insurance company. Most insurers already have legal teams ready, so it’s especially crucial to prepare yourself for what’s to come.
Depending on any and all losses you faced because of your insurer’s acts, you may receive compensation for:
Completing a construction project is already a challenge on its own. When your insurance company doesn’t support you, it can cause you to feel overwhelmed. If you believe your claim was denied without a valid or legal reason, then do not wait to contact the insurance attorneys at Millin & Millin.
Our legal team is well-versed in bad faith insurance claims and construction accident litigation. Let us assist you through this process so you can finally get the compensation you deserve.
Have you ever had a questionable or unfair insurance claim settlement in Texas? If so, you may be able to challenge the decision with the help of the bad faith insurance claim lawyers of Millin & Millin.
One party that can be held legally liable for an act of insurance bad faith is the insurance adjuster who handled your claim.
Many people are unaware that insurance claim adjusters — who investigate cases on behalf of the insurance company— can face civil lawsuits in Texas for errors and omissions (E&O) whether they are company, independent or public adjusters. Our bad faith insurance insurance lawyers can determine whether the insurance adjuster lived up to their duties and obligations as fiduciaries under the Texas Insurance Code.
Unfortunately, adjusters are sometimes sued unnecessarily either to pressure them to implicate the insurance company’s policy or to defeat diversity jurisdiction (keeping the case out of federal court).
Such cases are usually clear-cut and only result in wasted time and money for everyone involved.
A 2018 Insurance Litigation Report on 93,000 federal district court coverage cases between 2009 and 2017 found that in cases involving bad faith claims, approximately 90% found no bad faith on the part of the insurer, though most of these were resolved by summary judgment – when taken to trial, bad faith findings were closer to evenly split.
To bring a successful civil lawsuit against adjusters in Texas, there must be clear facts and evidence or at least red flags that the adjuster has acted in bad faith, either on their own initiative or on behalf of the insurance provider. Some examples of bad faith acts done by an insurance adjuster include:
Insurance claim adjusters are not neutral third-parties acting on behalf of a corporation that bears all the risk and blame – adjusters have multiple duties under the Texas Insurance Code and can be sued individually or jointly in bad faith cases. These duties include accurately representing facts and policy provisions to both parties (policyholder and insurance company), providing a reasonable explanation for a denied claim or settlement offer, and conducting a reasonable investigation prior to denying a claim.
Having a contractual obligation to the insurance company is not an excuse that adjusters can use to justify unfair decisions or deceptive practices.
Bad faith claims are often successfully prosecuted in cases of property damage or auto accidents where there is personal injury or even death (frequently involving payouts due to uninsured motorists). If you believe you have been the victim of a questionable or inequitable insurance claim settlement, contact a bad faith insurance claim lawyer as soon as possible to hold the adjuster and/or insurance provider responsible.
As the baby boomer population reaches their senior years, they have begun to seek out the benefits of the long-term care insurance they purchased years ago. These policies were set to provide benefits which are not normally included in traditional health insurance policies.
However, these long-term care policies have lead to a substantial growth of bad faith claims as insurers sold policies without disclosing important information regarding price inflation, reduction or denial of benefits, and failing to inform policyholders of restrictions.
At Millin & Millin, our bad faith insurance lawyers are dedicated to ensuring you receive the benefits that are owed to you. Those who have been denied a long-term health care policy claim should seek out legal aid to obtain the benefits they are legally owed.
Long-term care policies are aimed at providing seniors with the health care services they need as they age. Unfortunately, this is a vulnerable population who often suffer from the fraud and abuse of clever insurers who fail to provide adequate information regarding coverage.
Long-term care policies should cover:
When bad faith insurance takes place, seniors may face unexpected - and costly - expenses due to a lack of coverage for the services they need most.
Policy Definition and Limited Benefits
In addition to limits of benefits set in the policy definition section, most long-term care policies set daily benefits for reimbursement on care such as adult day care, home health care, nursing home cure, or assisted living facilities.
In addition to this, limited daily benefits can include care providers when necessary, as well as home modifications for easier access and to create a safer environment.
Not being able to perform two Activities of Daily Living (ADL) is used as a reference for determining benefits for physical or cognitive disabilities. ADLs include: bathing, eating, drinking, walking, standing, dressing, transferring, and other activities.
Issues with Long-Term Care Policies
Many of the long-term care policies were sold to in the mid-80’s and 1990’s to baby boomers who wanted to have protection already in place for when they would reach their twilight years.
The issues with long-term care policies started years ago when the policies were being underwritten. Underwriting is the process in which insurance underwriters measure risks and determine how much a premium should be to provide the coverage needed.
Unfortunately, insurance underwriters failed to properly estimate the inflation of costs associated with the services needed by this aging demographic including nursing homes, assisted living facilities, in-home care and more. Now, insurance companies are denying these long-term care claims and are substantially increasing premiums to the detriment of those who need the care most.
In order to fully understand your coverage limits and benefits, it is best to seek help from a professional bad faith lawyer.
The experienced attorneys at Millin and Millin have years of experience with bad faith insurers and can spot hidden limitations, reveal unfair practices, and help you to receive the benefits that are owed to you.
A class-action lawsuit filed in 2012 has finally been settled with a big name in the insurance industry having to pay out those they have wronged.
State Farm has gathered the attention of the public eye recently when they settled a class-action lawsuit for $250 million. It was claimed that the company tried to defraud 4.7 million past and current customers out of $1.05 billion that was rightfully owed to them.
Trust your bad faith insurance attorneys at Millin & Millin to stay up-to-date on major insurance news in order to deliver top-quality representation designed to get you the compensation you deserve.
The alleged debacle originally began more than 20 years ago, specifically, in 1997. The lawsuit at that time claimed that State Farm did not pay for original parts when vehicles insured by them were repaired.
In 1999, a Williamson County jury and judge ruled in favor of the plaintiffs, awarding them $456.6 million in damages for breach of contract, another $600 million in punitive damages against State Farm for violating the Illinois Consumer Fraud Act, and disgorgement damages totaling around $130 million. Not long after, an appeals court scratched out the disgorgement damages.
State Farm insurance would go on to appeal the judge’s original ruling and the lawsuit stayed in a legislative limbo of sorts within the Illinois Supreme Court. It was then alleged that State Farm had violated the Racketeer Influenced and Corrupt Organizations Act (RICO Act) by funneling money through several advocacy groups to certain political figures within the Illinois Supreme Court with the goal of keeping their donor list anonymous.
By keeping the donor list anonymous, this allegedly enabled State Farm to funnel more than $4 million in aid to the campaign of then-candidate, Lloyd Karmeier, back in 2004, who was running for the Illinois Supreme Court.
Karmeier would go on to win, and a mere 9 months after his election, he overturned the judgment on the original class-action lawsuit from 1999.
After a U.S. Supreme Court ruling that stated that a different West Virginia judge should have recused himself in a somewhat similar situation, blood—figuratively speaking—began to churn in the legislative waters, attracting plaintiffs and lawyers alike to investigate this ordeal.
In 2012, a federal racketeering lawsuit was filed.
The amount recently awarded, $250 million, was calculated to include the costs of administering the settlement, lawyers’ fees, and other costs.
The settlement also covered those from the original class-action lawsuit that were insured by and had filed an accident claim through State Farm and were given—or paid for the value of—a non-factory authorized or original part when their vehicle was repaired between July 28, 1987, to February 24, 1998.
It is important to note, however, that even though State Farm settled, they are not admitting guilt.
Every day, millions of people place their trust in the hands of their insurance companies, hoping that one day, should they need them, they will have their back.
The reality is, however, that sometimes insurance companies will put their profits over your best interests, and if that happens, you need the best bad faith insurance attorney. You need the expertise of Millin & Millin.
Contact us at (956) 631-5600 for your free case evaluation today.
The 2017 hurricane season was the most expensive in U.S. history, causing over $200 billion in damages. This was especially true of Harvey in Texas.
As a business owner in the Rio Grande Valley, your business is much more susceptible to flooding, hurricane damages, and other weather-related damages. While commercial property insurance will help to cover physical damages to your business, Business Interruption Insurance (also known as Business Income Insurance) helps to cover expenses and lost income that come as a result of the disaster.
With the 2018 hurricane season underway, now is the time to consider purchasing Business Interruption Insurance. If you are unfamiliar with how it can protect your business after a major catastrophe, your bad faith insurance claim lawyers at Millin & Millin would like to inform you about how it can be the protection you need to save your business.
Please consider the following information.
Business interruption insurance is an additional rider that you can purchase from your commercial property insurance provider or other specialized agency. There are various types of this insurance which cover a variety of different situations and damages including:
Extended and contingent coverages can be purchased as additional riders of regular business interruption insurance.
What your policy covers is dependent on the business assets that you want to protect. Every policy will be unique to a business owner’s specific needs. As always, it is important that you read through the policy and have a solid understanding of the coverage.
Generally, business interruption insurance can cover and protect:
Coverage is triggered when an incident - as specified by the contract - causes damage to your business and extends for however long as determined by the policy. Please be aware that business interruption insurance is limited and any losses that exceed those limits are the responsibility of the business owner(s).
There are a number of factors that play into the amount of coverage your business needs. Consider the following when determining what level of coverage you may need:
In an area like the Rio Grande Valley, which can experience a major disaster like a hurricane, it is important to have coverage that will protect your business for more than a few days.
However, even with the right commercial property insurances in place, your insurer may attempt to underpay or outright deny a valid claim. When this happens, don’t allow bad faith insurance tactics to derail you or your business. Depend on the responsiveness of the bad faith insurance legal team of Millin & Millin to get you the justice you deserve when seeking your rightful compensation after a natural disaster like a hurricane.
Contact us today at (956) 631-5600 to get the legal representation you need. Millin & Millin serves the greater McAllen metro area and the whole Rio Grande Valley.
