Unfortunately, accidents happen and things don’t always go as planned. An insurance claim that's denied only adds to the frustration of an already difficult situation. People end up in predicaments like this all the time, but why and how?
While some claims are denied in bad faith, there are many reasons why a health insurance claim may be denied with just cause. The bad faith insurance lawyers at Millin & Millin are here to present these key factors so that you’re prepared no matter what.
Though the specific details of each case differ, there are a few reasons frequently cited which can cause someone’s health insurance claim to wind up denied. Let’s explore some of these in greater detail:
Of course, you’re always able to appeal, and the company must cover your medical expenses if you succeed. If bad faith is involved, you may need the help of legal counsel.
Take it from the professional bad faith insurance lawyers at Millin and Millin, it’s vital to know what you’re covered for and why insurance claims are denied. If you’ve been denied in bad faith, reach out to our office to take the first steps to set things right!
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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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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.
COVID-19 has had a devastating impact not only on the American people, but also on the economy. Many businesses are closed in order to do their part to slow the spread. Because of this, business interruption relief is in high demand.
Unfortunately, many businesses are seeing their claims denied, even if their policy doesn’t exclude viruses.
In order to get the relief they need, many business owners have begun suing their insurance providers. Whether you’ve had your claim denied or simply want to ensure the strength of your claim in the first place, you may wish to seek the advice of a McAllen business interruption denial lawyer.
The pandemic has brought with it more than just illness. There are twin pandemics that have accompanied it.
For instance, many individuals and business owners are facing financial crises due to widespread anxiety, restrictions, and stay-at-home orders. To be clear, social distancing and staying home are essential parts of an effort to combat the virus. However, while these efforts are necessary, they also deeply impact businesses and the economy in general.
These hardships seem to be unavoidable in a pandemic, but that makes insurance policies and government aid all the more important. Despite this, many businesses have had their business interruption claims denied by insurers who claim their services were never meant to address these sorts of losses. An increasing number of business owners have filed suits against their insurers in order to seek relief.
If your business interruption was denied, you may need to take your insurance company to court to seek any compensation you may be owed. Meanwhile, many state governments and the national government are considering legislative solutions to this coverage issue. All of this can make the process of filing a business interruption claim in the first place even more confusing, unfortunately.
In truth, deaths and cases of COVID-19 have risen and fallen countless times over the course of the pandemic, but those small changes can be averaged into distinct “waves.” According to data reported by The New York Times, the U.S. experienced an initial peak in cases in late April and another, much higher wave in mid-July.
Currently, the country appears to be approaching another peak. In fact, cases on October 23 were at an all-time high. It’s likely that the pandemic, and the precautions needed to combat, aren’t going anywhere for some time.
And it’s possible that tighter restrictions may be called for either nationally or locally in order to get the virus under control.
The key to getting the business interruption compensation you need during this time is understanding your insurance policy. In order to determine if your policy covers losses such as those caused by COVID-19, you will need to identify any exclusions that may apply.
If you’re unsure if there is a virus exclusion in your policy, we recommend seeking legal assistance from a business interruption denial lawyer.
Even if your policy doesn’t have a virus exclusion, your claim may still be denied. Insurance companies know that many, if not most, of their policyholders, will be filing claims. However, insurance companies are also in the business of making money. Because of this, they will take any possible opportunity to deny your claim.
COVID-19 is hurting us all right now, but we can make it through this pandemic by supporting each other. One of the best ways to slow the spread is by simply going out less. However, this drop in foot-traffic has made staying afloat difficult for businesses across the country.
One life-preserver many business owners are reaching for is business interruption insurance. If you’re considering this option, the McAllen business interruption denial lawyers of Millin and Millin can help you analyze your policy in order to improve the strength of your claim. If you filed a business interruption claim only to receive a denial, we can help you challenge your insurance company in order to seek any relief you are owed.
For two decades, Millin & Millin, PLLC has represented hundreds of policyholders in their fight against insurance companies who wrongfully denied or underpaid their commercial property insurance claims. During this time, our firm has litigated claims for business interruption and property damage for hotels, retail centers, churches, office buildings, warehouses, and public schools all over the country.
Due to the government’s decision to issue shelter-in-place orders because of the COVID-19 virus, we know that many business owners are suffering tremendous losses in revenue. While many have coverage for business interruption and orders issued by a civil authority, we expect the industry to attempt to avoid paying trillions of dollars in legitimate claims. Insurance agents and adjusters will tell you that your building must sustain “direct physical loss or damage” before coverage is triggered, but we know this is not always the case.
Simply put, insurers will save themselves money by issuing a broad range of wrongful denials, and they will eventually settle the relatively small proportion of lawsuits filed by policyholders who are willing to fight for what is rightfully their money. Millin & Millin, PLLC is uniquely qualified to represent consumers like you in this battle. Call or email us today so that we can conduct a free review of your policy and provide you with advice you need to make the appropriate decision for your business during this tumultuous time.
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.
At the beginning of the new year, many people often make resolutions to better themselves. From eating healthier to exercising more, saving money to completing a project, we all make goals for the year.
In 2020, resolve to better protect yourself and your loved ones by performing an annual insurance review. This simple act can save you from a ton of problems should you have to file an insurance claim down the road. By knowing exactly what coverage you have and - perhaps more importantly - what you are missing, you’ll be able to make the right decisions about your insurance needs.
Your insurance claim lawyers at Millin & Millin highly recommend you review your policy at the start of every year with your insurance agent. Here’s why.
If you have coverage for any of your property - including a home or other valuables - you may find that you are actually underinsured because of how property value increases. For instance, if the property value of your home is greater than the cost of when you first bought it, then you may not have enough coverage to rebuild in the event of a catastrophe.
For example, if you paid $150K for your home but over the years its value has increased to $250K, then a lack of coverage could leave you footing the bill on any damages suffered.
When reviewing your insurance policy, you may find the means by which to save yourself a bit on insurance costs, including taking advantage of discounts you weren’t aware of, adding extra coverage at no extra costs, or even taking coverage off of property you no longer have, such as a vehicle you recently sold.
Depending on your insurance provider, you may even be able to lower your premium if you have improved your credit score over the past year, decided to pay an annual premium versus monthly installments, or simply been with the company for a significant amount of time.
Businesses in the United States are expected to have certain policies in place in order to protect employees and clients. Failure to update your coverage can lead to substantial penalties, or even bigger issues, like being sued by another party.
It is much better to be proactive when it comes to your business and seek out adequate coverage so you can protect your business and yourself from financial hardship.
When performing an annual insurance review, there are several questions you will want to ask your insurance agent in order to ensure that you have the protection you need to keep yourself, your family, and your valuables safe.
Start the decade off on the right foot by reviewing your insurance policies. If it’s been some time since you last examined them, you’ll have the opportunity to make adjustments before disaster strikes. This can prove to be absolutely pivotal when making an insurance claim.
Unfortunately, even with the right coverage in place, insurance companies may still act in bad faith. If you are dealing with an insurer who does not want to pay out the coverage that is rightfully owed to you, then do not hesitate to contact the dependable and trustworthy insurance claim lawyers at Millin & Millin. We have the skill, knowledge, and compassion necessary to get you the results you need.
While insurance companies are obligated to compensate victims of drunk driving accidents, there have been instances where they attempt to avoid paying out by placing blame solely on the driver.
For instance, one agency attempted to classify a drunk driving accident as intentional in order to avoid paying the verdict. The insurer argued that because the driver chose to drink and drive, it was as if they were acting intentionally, which is not covered in their policy and thus they were not liable for damages.
The victim of the accident was forced to sue the insurance company as a result. Thankfully, the court ridiculed the logic of the insurance company and forced them to pay out to the victim.
This case was of great value to Texas drivers who have been injured in auto accidents caused by drunk drivers and who are having issues with the negligent party’s insurance company. You DO NOT have to deal with insurance company’s acting in bad faith when you have suffered a severe personal injury as the result of another party’s carelessness. Let the insurance claim lawyers of Millin & Millin help right the wrongs done against you.
In order to recover compensation for the damages and injuries you have suffered, you will need to file a claim against the drunk driver’s insurance provider. Unfortunately, this is often easier said than done.
Insurance companies - especially those acting in bad faith - may attempt to delay your claim in order to either frustrate you into taking a minimized settlement or in order to stretch the claim out until it has passed the statute of limitations.
In the State of Texas, individuals have two (2) years from the date they were injured in order to file a personal injury claim against the responsible party.
This means that you should seek out quality legal counseling immediately after you have suffered your catastrophe. Not only is it necessary so that you can file your claim within the proper time frame, but also so that you can also fight back against insurance company who is unlawfully denying or slowing down the claims process.
Whether you are misinformed by the negligent party’s insurance provider or if you simply do not know your rights, please be aware that the drunk driver does not have to be charged or found guilty of criminal activity in order for you to file a civil claim.
Whether or not the driver is found guilty of a DWI charge, you can still pursue a personal injury claim. Your attorney will need to provide evidence, however, that the driver was responsible for the accident - and simply using the DWI charge is not valid enough. Instead, your attorney will have to rely on the facts of the situation and focus on the exact cause, such as speeding or running a red light, in order to prove that the driver was responsible for your injuries.
A dependable attorney will thoroughly investigate the claim in order to recover compensation for your damages.
What Will the Insurance Company Cover After a Drunk Driving Accident?
Depending on the specific circumstances of your accident and the amount of coverage the liable driver has available, then you may be able to receive compensation to help cover but not limited to:
It is important to note that (1) if the driver only has minimum coverage then you may need to seek restitution through another manner and (2) you will only be able to receive compensation up to the policy limits of the insurance company.
Is the insurance company of the responsible driver trying to deny your claim or place liability strictly on the driver? This is known as bad faith and you have the right to seek justice against this type of illegal business tactics.
Suffering from a serious accident and having to make an insurance claim can be scary and frustrating. Sadly, many insurance companies will not make it any easier on you and may make you jump through hoops just to receive the coverage that is rightfully yours.
Do NOT accept this type of behavior.
The past few years have seen a few devastating hurricanes cause massive amounts of damage to Texas’ coastal region. While we here in the Rio Grande Valley have been fortunate to avoid any catastrophes, the reality is that a major storm can eventually hit our region.
That’s why being prepared this hurricane season is so important.
You not only want to have a plan in order to protect yourself and your loved ones, but you also want to make sure that you have the right insurance coverages in place so that you don’t have to handle the costs of hurricane damages all on your own.
Let the dedicated bad faith insurance claim attorneys of Millin & Millin provide you some tips that can help to minimize any storm damages while also giving you insight into additional insurance policies you may need to purchase.
Before a hurricane or tropical storm hit, you’ll want to take the proper steps to protect your home and property.
a. Inspect your roof for any damages such as leaks, loose or missing shingles, cracks, or other signs of roof damage that could become a major issue should a hurricane strike. Get it fixed as soon as possible.
b. Double check that your windows and doors are properly sealed with caulking.
c. Check your home’s gutters and drains for any damages that can lead to water leaking into your home.
d. Clean up your yard including trimming loose branches and placing loose objects into a storage room or home.
If a storm is definitely going to hit the region, you’ll want to protect your windows by using plywood or having storm shutters installed if possible.
Alongside physically preparing your home for a storm, you’ll want to make sure you have the right insurance coverage.
Many homeowners do not know exactly what their insurance covers and this can lead to a world of financial trouble if they aren’t careful.
Generally speaking, home insurance policies typically do not cover flooding and certain other damages that can occur if you live in an area prone to hurricanes, tropical depressions, or floodings. To ensure you are fully protected, start investigating as to whether or not you will need:
While we hope that our region will be able to avoid any major storms this hurricane season, we also want to ensure that the people of the Rio Grande Valley are fully prepared. Should your home suffer severe damage caused by a storm and you cannot secure the coverage to you, do NOT hesitate to contact the experienced insurance claim attorneys of Millin & Millin.
