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!
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The pandemic has affected all of us in a wide variety of ways, few of them good. Along with the wave of harmful events that affected businesses and individuals alike came a wave of insurance claims related to that harm. Unfortunately, proving your right to compensation can be difficult, and insurance companies will often do what they can to minimize or outright deny you what you’re owed.
Because of this, it’s important for all Texans to know their rights and what they can do if those rights are challenged. Today, your committed McAllen bad faith insurance attorneys at Millin & Millin will explain how knowing your rights is the first step in protecting yourself.
The legal rights that each of us has in the U.S. are complex and varied, but one major component is our ability to seek damages for harm inflicted upon us. This includes instances such as suing for car accident damages or damages caused by a crime, while also including harm caused by negligence rather than direct action. Negligent harm occurs when an entity fails to fulfill its obligation to keep you reasonably safe.
There are many entities that owe you a guarantee of safety. Each time you enter a grocery store or walk through a parking garage, the owners of those properties are responsible for taking action to protect you from foreseeable harm. This includes using cameras, keeping floors clean, and providing adequate lighting.
You can also be a victim of harm when an entity sells you a faulty product or drug. In these cases, the seller has a responsibility to provide you a reasonably safe product. If they fail to do so, then you have the right to seek damages for any harm that you suffer as a result of using their defective product.
While the aforementioned rights laid out primarily deal with physical injuries, you also have rights related to your property. Some of these rights are directly related to the examples above. For instance, property damage might be included in car accident compensation along with compensation for medical expenses.
In most cases, the compensation awarded to victims comes from an insurance claim, but those claims are usually made with the insurance company of the at-fault party. For example, if someone else causes your car accident, their insurance policy is meant to cover the damages. Similarly, if you are injured in a place of business, the insurance policy of the business owner should cover your costs.
However, there are other insurance claims that you will need to make under your own policies. These claims include claims for business interruption, property damage, and other types of business-related harm covered under your specific policy.
You have the right to make a claim against any type of damage covered in your insurance policy. Unfortunately, your insurance company may attempt to stall, mislead, or flat-out lie to you in order to avoid paying what they owe. In that case, you have the right to seek the assistance of a bad faith insurance lawyer to help you hold your insurance company accountable.
In many of the cases laid out above, getting the compensation you need comes down to whether or not the insurance company involved is going to act fairly. Because of this, it’s important that consumers and business owners have access to the legal representation of bad faith insurance attorneys.
Whether your house burned down or your business closed, you’re probably going to be making an insurance claim. If you feel that your insurance company is treating you unfairly or refusing to pay what you are owed, reach out to the McAllen bad faith insurance attorneys of Millin & Millin for help fighting back.
While most business owners are probably familiar with the more common types of insurance claims, they may be at a loss when it comes to seeking coverage for more rare types of damage. After a year like 2020, business owners are probably dealing with some pretty rare kinds of losses.
Thankfully, those losses may be covered by a civil authority clause.
While a civil authority clause may offer coverage for losses caused by coronavirus restrictions, making a successful claim under this provision can be difficult, partially due to coronavirus claims being a new type of claim without clear precedents. Because of this, insurance companies may attempt to deny these claims using bad faith tactics.
Today, your McAllen bad faith insurance lawyers at Millin & Millin will go in depth regarding what you should know about civil authority coverage.
A civil authority clause is a provision of some business interruption insurance policies meant to protect the policyholder from the financial damage caused by a closure that was a result of orders made by a government official or other civil authority.
Essentially, if your business is closed after the government has prohibited access due to a natural disaster, you may be able to file an insurance claim under a civil authority clause.
It’s worth remembering that, under these forms of clauses, coverage is offered based on damage done to property other than the insured property itself. This means that if your store was damaged by a hurricane, you probably wouldn’t file a civil authority claim. However, if the hurricane caused damage to the road that once gave access to your business and authorities declared access to the affected area prohibited, then you may be able to make a civil authority claim.
A local or state government or other civil authority may order evictions or prohibit access to regions for many different reasons. A civil authority clause may include these, as well as a few other types of damages:
Keep in mind that not every civil authority clause will cover all of these types of closures. Insurance companies will use the specific language in your policy in an effort to argue against your claim.
If your civil authority closure business interruption claim has been denied, you may want to speak to a bad faith insurance attorney to determine whether or not your claim was wrongfully rejected.
Due to the relative unfamiliarity of coronavirus-related business interruption claims, certain insurers have used bad faith tactics to deny rightful coverage. Nevertheless, there are also ways that these claims can be denied that don’t necessarily constitute bad faith:
This list of possible denial justifications is non-exhaustive, and just because your insurer is using one of these arguments doesn’t mean that they are in the right to do so. If you have any reason to believe that your business interruption claim was wrongfully denied, reach out to the bad faith insurance attorneys of Millin & Millin for an argument that stands strong in your favor.
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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.
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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.
Trying to stay healthy and safe during the coronavirus pandemic is at the forefront of everyone’s mind right now. However, in order for social distancing to take place and be effective, businesses have had to adjust to local, state and federal mandated orders to either shut down operations or alter them significantly.
These changes have greatly affected the revenue business owners would normally bring in during this time frame. In order to stay afloat and provide for employees, many companies have been making claims against their business interruption insurance.
Due to the widespread need for financial help right now, insurance companies have been less accommodating to claims that are being filed.
If your insurance company is acting in bad faith and failing to properly deal with your claim, the team at Millin & Millin want to represent you. We can challenge insurers who refuse to provide you compensation and ensure you obtain the coverage that is rightfully owed to you.
For a business interruption claim to be accepted, there needs to be evidence of property damage and physical loss of use of certain kinds of assets. When these kinds of claims are approved, it’s typically due to the aftermath of natural disasters, fires or acts that damage the physical aspects of your business.
The challenge business owners are currently facing boils down to the lack of insurance law on viral pandemics. While these are unprecedented times, and the need for business interruption claims are widespread, businesses aren’t getting the help they need.
Part of the reluctance of insurers is their own efforts to save money, which causes the denial of viable claims. Because there aren’t specific laws in place regarding interruption claims made during a pandemic, it has been difficult for business owners all across the company to receive help from their insurers.
However, this doesn’t mean it isn’t worth your time to seek out restitution with the support of qualified insurance attorneys who can handle bad faith claims.
In an article from the Chicago Tribune, Thomas Bentz, an attorney on the insurance industry team at Holland & Knight said that the fight insurance companies are putting up boils down to economics.
Insurance doesn’t work where everyone has the same loss at the same time. If you have 100% loss across your portfolio, it’s not sustainable,” Bentz says.
The article also covered how new bills are being introduced across the country to require insurance carriers to cover business interruption claims filed due to Covid-19. This is progress and evidence that the government is holding insurance companies accountable for the new reality we are all living in. Unfortunately, these bills are not being passed in ALL states.
Millin & Millin has been working aggressively for the past two decades to represent individuals dealing with bad faith insurance companies. With our support, we’ll see to it that you are fully compensated so that you can preserve your company during these trying times.
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.
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 Texas Supreme Court’s opinion was issued on a case between homeowner’s insurance company, USAA Texas Lloyds Co. and Gail Menchaca. The high court reversed the decisions of both the court of appeals and the trial court judgement.
In 2008, following the destruction caused by Hurricane Ike, Gail Menchaca made a homeowner’s property claim to USAA.
An adjuster was sent to investigate the claim, who found minimal covered damage, which did not exceed the policy’s deductible. Because of this USAA declined to pay out any benefits.
Nearly five months later, Ms. Menchaca requested a re-inspection of the damages. USAA sent a different adjustor that essentially confirmed the initial findings. Again, USAA refused to pay out on any benefits.
The insured party sued USAA for breach of contract and for unfair settlement practices that violated the Texas Insurance code. Ms. Menchaca sought insurance benefits under the policy, court costs, and attorney’s fees.
The case was tried to a jury in Conroe, Texas.
The jury first determined that USAA had not breached the contract and thus no policy benefits were owed. While the jury also validated that the carrier had not infringed on five provisions of the Texas Insurance Code, they found that the insurer was in violation of not reasonably investigating the claim.
Because the jury found that USAA had been engaged in unfair trade practices, they awarded Ms. Menchaca $11,350 for actual damages and $130,000 in attorney fees. Nothing was awarded for contract benefits as there was no breach of contract.
Both parties motioned for judgement in their favor. USAA argued that the Ms. Menchaca was not entitled to statutory damages as they had effectively complied with policy standards. The trial court denied this motion and ruled in favor of Menchaca.
The recent ruling by the Supreme Court of Texas reversed these decisions and remanded that a new trial take place using the five new rules they developed.
The Supreme Court outlined five new rules in order to help answer the question of “whether the insured can recover policy benefits based on jury findings that the insurer violated the Texas Insurance Code and that the violation resulted in the insured’s loss of benefits the insurer ‘should have paid’ under the policy, even though the jury also failed to find that the insurer failed to comply with its obligations under the policy.”
The five newly established statutes are as follows:
The manner in which the Menchaca decisions plays out in future cases is still to be seen, but rest assured that your bad faith insurance lawyers at Millin & Millin are diligently following the changes in law that may affect your own situation.
Our bad faith insurance lawyers are strong advocates for McAllen metro residents who have had to deal with bad faith insurance tactics. Our attorneys possess superior experience and the necessary knowledge to bring forth an exceptional case.
Contact us at (956) 631-5600 for a free consultation.
