Every insurance company owes it to their policyholders to act in good faith. When an insured individual has been involved in a circumstance that directly affects his or her way of life, the policyholder usually files an insurance claim immediately so that compensation can be granted and to diminish unexpected financial burdens.
Lamentably, policyholders face deeper issues when their insurer deceives them.
Although acting in bad faith, or implementing unfair practices in a valid claim, is out of compliance with the Texas Insurance Code, insurance companies sometimes prefer to not fulfill contractual obligations for their own advantage.
Are you currently dealing with a bad faith insurance situation?
Let the attorneys at Millin and Millin represent your case.
Although insurance companies are responsible for bad faith practices, insurance adjusters also play a role in this wrongful behavior. Adjusters have the responsibility of processing and properly investigating a claim, developing reasons why a claim should be denied, and figuring out whether the policyholder was at fault in a given incident.
In most cases, adjusters will spend hours investigating and trying to find details and evidence that can aid in denying a claim. These acts help adjusters implement claim evaluation techniques that can have a negative effect on a policyholder’s claim.
Courts around the nation have concluded that an insurance company must have systems that their adjusters can depend on when evaluating a claim. Although a bad faith act should never be a company standard, nobody truly knows exactly how insurance companies operate, so it’s difficult to get a full disclosure of what happens behind closed doors. There are, however, recognized tactics that are utilized by insurance companies.
Below is a list of examples that can aid in identifying a bad faith act:
There are certain steps that can be taken if you believe that your insurance company is acting in bad faith. Those include contacting the adjuster’s supervisor or taking legal action in an attempt to recover what is owed to you.
Most people begin by gathering all the facts and vital proof that can be used to back up their assertion. It is also advisable that claimants keep their cool when attempting to contact a supervisor about the matter; cooler heads prevail and will help you to receive the attention of a higher authority rather than being disregarded as a vexed claimant.
After your conversation, stay in contact, and following up as needed. Make sure that you send a certified letter to both the supervisor and a copy to the adjuster. Summarize all the elements that were discussed by phone and add an additional paragraph that details why you believe your adjuster acted in bad faith.
Conclude by saying that you are hopeful that both the insurance company and adjuster will begin a fair negotiation of your claim and that you will seek legal representation if the situation does not change.
If you find that your claim was rejected even after attempting to come to an honest agreement, then do not hesitate to contact the attorneys at Millin & Millin. Our litigators have advocated 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.
The holiday season is one of the most joyous times of the year. There’s a wonderful abundance of family, friends, festivities, and cheer. But there’s also an increased risk for a holiday mishap. Especially fires.
Naturally, the first instinct is to turn to your homeowners insurance company after a disaster. Once a claim is filed, your insurer will send over an adjuster to evaluate the damage. Sadly though, the adjusters are representing the company’s interest first and foremost, which means the homeowner gets the short-end of the stick.
In a catastrophic house fire, for example, the insurer will often recommend a professional cleaning service to clean the carpets, furniture, etc., rather than pay replacement costs.
Rather than have to deal with the consequences of a bad faith insurance claim, consider taking the necessary steps needed to reduce these risks.
The National Fire Protection Association (NFPA) issued a report in 2015 that showed that between the years of 2009-2013, Christmas trees were responsible for an estimated 210 house fires per year; this lead to an annual average of 7 deaths, 19 injuries, and $17.5 million in direct property damage.
Although Christmas tree fires are not very common, when they do occur, they are more likely to cause serious damage. Consider the following recommendations to avoid a fire hazard:
The same study completed by the NFPA found that U.S. fire departments responded to an average of 860 home fires during the same time frame (excluding Christmas trees). Annually, these fires account for an average of 1 death, 41 injuries, and $13.4 million in direct property damage.
Additionally, candles accounted for 38% of home decoration fires, with half of those occurring during the month of December. Remember the following candle safety tips to avoid a holiday tragedy.
Fireplaces are uncommon in the McAllen metro area, but electric space heaters are still widely used during those occasional winter cold fronts. While necessary for many families, the NFPA urges caution and ask the public to practice safe heating tips. Though electric space heaters only account for 32% of home heating fire involved space heaters, they cause 79% of home heating fire deaths.
The leading factors for space heater fires includes the equipment being too close to combustible items such as furniture, clothing, and mattresses, as well leaving the space heater unattended.
Millin & Millin bad faith insurance lawyers offer the following tips.
Even the most vigilant, safest family has accidents. If you are having to file an insurance claim, it’s likely due to the fact that you have just suffered through a terrible event. Having to deal with the unscrupulous tactics of an insurance company is the last thing you need on your plate during this time.
Depend on the responsiveness of the Millin & Millin legal team to get the justice you need when seeking your rightful compensation from deceitful insurers.
Contact us at (956) 631-5600 to get the legal representation you need.
If there isn’t any damage there can’t be any injury right? Wrong!
After a low speed impact collision, your insurance company may associate a lack of damage as an absence of injury. But this isn’t always the case. It is entirely possible for passengers in a auto accident to be injured, especially in soft tissue areas such as the neck and spine.
If these injuries occur and an insurer is involved, the adjuster assigned to the claim will attempt to minimize the compensation received. Unfortunately, this means offering the injured party the lowest amount possible without having to litigate.
A tactic that the adjuster will use might be pointing out the lack of visible damage to the vehicle. This sort of misused logic is a myth, as numerous studies have found that even though there isn’t much damage to a vehicle, it doesn’t mean that injuries haven’t occurred. In a low speed collision, the speed of the vehicles at the time of impact is only one factor that should be analyzed to determine the value of a claim.
One of the reasons that car wreck victims can sustain connective tissue injuries is because bumpers are not designed to crush in low-speed collisions, but are instead intended to minimize proper damages, as regulated by the National Highway Traffic Safety Administration (NHTSA). In fact, the NHTSA specifically mentions that bumpers are “not a safety feature intended to prevent or mitigate injury severity to occupants in the passenger cars.”
Furthermore, when a car is involved in an accident, seat belts will lock in place and cause the occupants’ bodies to thrust forward. While seat belts are great at decreasing injuries, they do inhibit body movement, but not head movement, which means your head can forcefully snap forward and then backwards in what is known as whiplash. Essentially, injured victims cannot brace themselves effectively on impact and their bodies are forced into unusual positions that may cause “soft tissue” trauma.
Car wreck cases exist in a specialized realm of knowledge known as wreck dynamics, which includes physics, biomechanics, biology, and other such fields. Many of the questions surrounding a car wreck and the sustained injuries are affected by scientific principles and only a qualified expert should give an opinion on issues that include:
The specialized knowledge needed to answer these questions is usually outside the realm of common understanding and can easily lead to the jury having to speculate or guess about the answers to these questions. The insurance company may argue that these questions are easily answers, but peer-reviewed scientific studies have debunked this argument.
A set of guidelines developed in the mid-1990’s, and presently used, are known as the MIST protocol and instruct claims adjustors that crashes with minimal damage are unlikely to cause significant damage or personal injury. This training system suggest vehicle damage is tied into injury presence, and that claims of $1000 or less are false
These guidelines recommend that regardless of medical evidence of an injury, these “fraudulent claims” should be remedied without lawful payment to the insured. Many insurers have adopted similar handling processes that focus strictly on the relationship between vehicle property damage and the potential for injury.
Regardless of medical evidence of injury, insurers may attempt to approach a claim through “common sense” assumptions rather than a scientific proof.
Insurance companies may try to use the myth of no damage equals no injury in hopes of getting you too frustrated to fight with them and thus accepting their low offer. That’s why it’s important to remember the truth that there is no scientific evidence or study that support the industry’s hypothesis based on this myth.
Instead, if you are injured, even in a small fender-bender, make sure you get medical treatment immediately. Medical records that prove you sought treatment and the doctor’s diagnosis of your injuries will prove to be vital in rebuffing insurance adjusters. You’ll also need to follow your doctor’s treatment plan, keep appointments, and maintain an organized file of medical records to show you followed the treatment.
If after several attempts to rectify the issue and negotiate a claim effectively, the insurance company continues to act in a malicious manner, contact Millin & Millin PLLC immediately at 956-631-5600.
Bad faith lawsuits can be complicated, but our experienced lawyers have the know-how to deal with any insurance company – big or small.
“Know what to look for to avoid claim denials.”
Dealing with a major illness is enough stress as it is. There’s no reason any one should add to your burdens, but sometimes insurance companies can make it downright difficult in helping you get the resolution you need by denying your claim and leaving you with a large medical bill on your hands.
However, it’s still very important that you understand the reason for the denial so that you can take the necessary steps to appeal the decision. While there is always the slim chance that the denial was simply an insurance company error, the likelihood is far greater that you were denied coverage for a number of reasons - especially if this was your first submission.
The attorneys at Millin & Millin PLLC want you to know that you do have the legal right to appeal the insurer’s decision, as well as request the support of an experienced and dedicated legal team that knows how to deal with bad faith insurance practices.
What is important to know about the appeals process is that action must be taken immediately as there is usually a time limit set in place by the insurer - usually about 30 to 40 days after a denial. Make sure that you ask for a written denial from the company (via certified mail) that explains to you the denial details so that you can make an informed decision on what action to take next.
It’s also vital to go into this situation well versed, so we offer you 5 reasons why your insurance company might have denied your claim.
One of the typical reasons for having your claim denied is for receiving services outside of your plan’s provider network. If you received elective or nonemergency care from a provider that was outside of your health maintenance organization (HMO) or exclusive provider organization (EPO), then this means you obtained care from a party that was not in agreement with your insurance company’s terms of payment. In this situation, your health plan may deny the entire claim and make the payment your sole responsibility, or it may require of you to pay a bigger portion of the costs. Contact your insurer to find out more about your HMO’s network of healthcare providers.
Another highly possible reason for the claim denial was that the procedure you received simply was not covered by your insurance policy. It’s going to be your responsibility as the policyholder to know exactly what is and what is not covered in your plan. While it can be easy to make assumptions about certain routine procedures, always double check with the terms of your policy to ensure that the specific treatment you are seeking will be covered by your insurance. If you know that you’ll need a certain form of health care that is currently omitted from your plan, then make the decision to shop for a new policy that will provide you what you need.
Mistakes happen, and hopefully, it was simply an accident in the billing department of your local clinic that caused the mishap. While it can be frustrating to have to deal with these minor inconveniences that turn into seemingly big problems, billing issues can be quickly handled. Something as simple as your provider having outdated insurance information on file can lead to a denial. Issues can also arise from having two policies, such as having coverage through own employer and your spouse’s. If you can’t figure out exactly what the issue is, then have a talk with your doctor’s billing department and try to find out if they accidently coded your claim improperly or excluded some vital information.
Your doctor’s billing department can make mistakes and so can your insurance company. Transcription errors on reports developed by the insurance company can mean denial. A misspelled name. An incorrect birthday. Incorrect procedure codes that are age appropriate can make the claim invalid. Minor data entry errors can definitely snowball into something bigger, but all you have to do is call the patient customer service representative to help get the data problem fixed.
Certain procedures will require preauthorization, which is initiated by a doctor’s request on your behalf. Depending on the given situation, the procedure may be denied by the specialist provider if there is no preauthorization, or you may have the procedure done but the claim is denied afterwards. If the latter should take place, then ask your doctor to contact your insurance company and explain to them that a referral/preauthorization did occur. This is essential because if the insurance carrier does not have the valid referral number, the claim with be denied until the referral is provided.
After making timely payments on your premium, it can be a shocking discovery to find out that your health insurance claim has been denied. Sadly, insurance companies aren’t always looking out for your best interest, and that’s why you’ll want a legal team that will.
The Millin & Millin PLLC attorneys are fully aware of the dubious nature of insurance companies and so we strive to provide clients with the most reliable legal consultation to help ensure that you get the rightful benefits you are owed.
While it’s important to anticipate some of the common causes of rejected health insurance, if your insurer continues to practice bad faith, then give the Millin & Millin team a call at (956) 631-5600 and we’ll make sure you don’t have to deal with their tactics again.
If you are having to file an insurance claim, it’s likely due to the fact that you have just suffered through a terrible event. Having to deal with the unscrupulous tactics of an insurance company is the last thing you need on your plate during this time.
Luckily, there are steps that you can take to help you avoid the frustration of dealing with purposely dragging insurance companies. You can also depend on the responsiveness of the Millin & Millin legal team. Our dedication to justice and results means you get the support you need when seeking your rightful compensation from deceitful insurers.
On top of having Millin & Millin as your advocates when dealing with bad faith tactics, we also recommend utilizing technology to help you work through the claims process. Web tools, insurer apps, and even smart-phone cameras can be vital resources to help you gather evidence, prepare a claim, and submit information to help support your case.
Unfortunately, even when following the appropriate measures to ensure a successful - fully paid claim - your insurer may still attempt to pay you less than what is rightfully yours. Fight back with these tips.
With today’s technology, you no longer have to physically write down everything you own. Nowadays, you can just utilize the camera on your smartphone or tablet to take video of all your possessions, as well as details about your home and its architecture.
You’ll want to take as many pictures as possible, as well as note down any attention grabbing details about your home. The more information you have on hand, the easier it will be for you to recall the particulars should you file a claim at some point.
If you should experience a house-damaging event, then photograph the source of the damage. After taking the necessary steps in gathering information (i.e. pictures and video) then go ahead and do what you must to prevent further damage. However, do not commence with cleanup or repairs until the insurance adjuster has visited you.
When the claims process begins, remember that insurer apps can make sending pictures and other records to the company much more efficient, so take advantage of these options. Also, keep in contact with the adjuster frequently (once a week) by phone or email. During the repairs process, keep receipts for any expenses you paid for as a direct result of having of the damage occur (i.e. supplies used to help contain the damage).
Be aware that filing a small claim may cause a rate increase, so if possible, fix the issue yourself to avoid having a higher premium.
Fighting back: If your insurer continues to hassle you over miniscule or irrelevant details during the claims process then get in contact with your state insurance department. There are usually free services that the department offers that will help you through the claims process and help to ensure you get the legal compensation you’re entitled to under your policy.
Car accidents happen in an instant, but the effects can be felt for a lifetime. Though the stress of being an involved in an accident can make it challenging to gather all the information needed for an insurance claim, try and remain calm.
It’s essential that you do NOT simply exchange insurance and contact information with the other driver(s), but that you also take pictures of the incident. Take photos of the damage to your car, the damage to other cars involved, the accident scene, weather conditions, license plates, registration and insurance cards. If possible, get contact information from witnesses for future purposes. When police arrive and create an accident report, get the report number and a copy of the forms.
When all vital information has been gathered, contact your insurer.
You can generally use any repair shop to get your car fixed, but following the insurer’s recommendations may help to expedite the process.
Fighting back: If the chosen body shop claims that the repairs will cost more than the appraiser says, provide the shop’s estimate to your insurer. There may be differences in costs because of policy specifics, but in these scenarios you have the right to get an independent appraisal. Recruiting an independent party to your case may help you to settle the claim closer to what you feel is fitting.
If your insurer claims that the car is totaled, but value it at a significantly lower price than anticipated, then do some investigation into the selling prices of used cars with similar conditions as your own. You can also ask for the reasoning behind the lower payout. If you feel like the payment is still too low, contact your state insurance department.
Health insurance claims can be an exhausting experience because of a third party - your health care provider. During the purchasing phase of health insurance try and get a clear understanding of what exactly a policy will and will not cover - as well as service requirement specifications. For example, is pre-approval needed to obtain services at certain facilities?
Also, pay attention for out-of-pocket costs for an out-of-network provider. These charges tend to be higher than with in-network providers and processing them may be burdensome because the out-of-network provider has not set up a claims link with the insurer. Make sure to call your insurer with any questions you may have about out-of-network coverage and to take detailed notes of the conversation including date, time, the person you spoke with, and conversation points.
When making a claim, compare the doctor’s bill with the insurer’s explanation of benefits (EOB). Also, be aware that the doctor’s office may have sent you a bill prior to filing a claim with the insurer, so do not pay until you have received the EOB.
Fighting back: Claim denials may just be related to administrative problems, and occur for a number of reasons including the insurer needing additional information from the doctor or a mistake in the billing coding. It is highly recommended that you avoid simply making repeated phone calls and instead immediately go into the appeal process.
Your state insurance department can once again be of great benefit prior to the appeal. They can provide you guidance and information, especially when dealing with large claims. Make sure you have the proper evidence and documentation from your doctors on why a given procedure was necessary.
If after several attempts to rectify the issue and negotiate a claim effectively, the insurance company continues to act in a malicious manner, contact Millin & Millin PLLC immediately at 956-631-5600. Bad faith lawsuits can be complicated, but our experienced lawyers have the know-how to deal with any insurance company – big or small.
If after several attempts to rectify the issue and negotiate a claim effectively, the insurance company continues to act in a malicious manner, contact Millin & Millin PLLC immediately at 956-631-5600. Bad faith lawsuits can be complicated, but our experienced lawyers have the know-how to deal with any insurance company – big or small.
After timely payments on your premium, and faithful customer loyalty to your insurance company for years, it may come as a shock to discover that your insurer may not be as compassionate to you as you would’ve hoped. The haunting truth is that though insurance companies are not purposely wicked, however their loyalty ultimately lies with profits.
The attorneys at Millin & Millin PLLC are aware of the dubious nature of insurance companies and so they strive to provide their clients with the most reliable legal consultation when facing civil litigation challenges - especially against these large business entities.
There are a number of issues that can arise when dealing with insurers and one of the worst is bad faith insurance. Unfortunately, customers aren’t usually cognizant of bad faith insurance until they are attempting to file a personal injury claim. This is when bad faith denial of claims begins to emerge, which is illegal, and which can affect the claims tremendously.
Fortunately, with the right team of attorneys by your side, you can fight these illegal actions and gain back the benefits that are rightfully yours. Because bad faith insurance is unlawful, companies are susceptible to fines and punitive damages, which can run into the hundred of thousands of dollars or even the millions.
When negotiating insurance claims, adjusters may act in bad faith.
Bad faith insurance practices are the refusal, denial, underpayment or delay of a legitimate claim by a policyholder. When an adjuster of the insurance company denies a claim for no reason, then it could be that your insurer is acting illegally.
Bad faith is whenever an insurance company:
Unfortunately, bad faith practices occur way too often, especially because insurance companies maliciously take advantage of the fact that most policyholders aren’t always aware of their rights or legal options when being mistreated.
Bad Faith Insurance Laws
Thankfully, there are laws set in place to help prevent bad faith insurance practices from occurring. These laws allow individuals to to take legal action from mistreatment and protect policyholders from unethical practices.
If your insurer continues to deny you a fair settlement, then you can file a complaint with your state insurance board. An investigation will help to determine if the insurers were acting in bad faith. However, the insurance board can only levy fines against the company, but CANNOT force them to pay a claim. This means you’ll need a competent and experienced law firm like Millin & Millin PLLC to help you file a suit against them.
When is it Not Bad Faith?
A simply disagreement between an insurance adjuster and policyholder about the total loss amount does not necessarily represent a bad faith practice. It is important to remember that a simple mistake or error caused by the insurer does not necessarily mean that they were acting in bad faith.
Who is the Claims Adjuster?
Claims adjusters are employed by the insurance company to help process claims. Their responsibilities include:
Is Your Adjust Acting in Bad Faith?
If you are under the belief that your adjuster is acting illegally, then the first thing you will want to do is file a complaint with that adjuster’s supervisor. Note the reasons why you believe the adjuster is negotiating in bad faith and discuss your concerns with the supervisor. Make sure that you do not initiate the conversation with threatening to file a suit as this will only cause them to treat you as a disgruntled customer rather than with the consideration you deserve
Inform the supervisor that:
To be taken seriously it will exceedingly vital that you gather (and offer) as much proof of the bad faith dealings as possible. Always take good notes when talking with your adjuster so that you can provide viable examples of the bad faith tactics.
After the discussion with the supervisor, send them a certified letter that confirms the date and time of the conversations. Also reiterate the reasons you believe the adjuster is acting illegally.
When You Need an Attorney
If after several attempts to rectify the issue, and negotiate the claim effectively, the insurance company continues to act in a malicious manner, then contact Millin & Millin PLLC immediately. Bad faith lawsuits can be complicated, but our experienced lawyers have the know-how to deal with any insurance company - big or small.
We know that pursuing a case against a company on your own can be intimidating. That’s why we want to be the support you need and deserve. Call the Millin & Millin PLLC offices today at 956-631-5600 to help you secure the coverage and benefits you are owed.
It’s that time of the year again when our little ones and teens start their weekly treks to and fro school. Whether you drop them off, they walk, or they drive themselves, it’s important to remind your children about the necessary precautions to take when on the road and at school. From the playground to driving responsibilities, all children need to be aware of the risks that can lead to personal injuries.
Personal injuries can be very traumatizing for your child, and insurance agencies don’t always work as morally or effectively as they should. That’s why you need attorneys like Millin & Millin PLLC who will help you pursue the matter in an aggressive, yet meticulous manner, until you obtain the resolution you deserve.
Our lawyers at Millin & Millin PLLC are dedicated to your family and want to protect your loved ones by providing you with a few back-to-school safety tips to get them back home and safe in their bed every night.
The National Program for Playground Safety reports that 80 percent of playground injuries are caused by falls. That’s why it is important to remind your child to remain aware of their surroundings at all times and to avoid running on or jumping off of playground equipment. Also, make sure your child’s playground equipment is free from dangerous protrusions that can lead to wounds or head entrapment hazards that can cause serious neck injuries. Your child should also be adequately supervised, either by their teacher during school or by you during visits to the park.
Thousands of school buses safely transport millions of children throughout the U.S. every year, and though there is the occasional accident that makes national headlines, buses are a traditionally safe mode of transportation. However, there are some guidelines your child should follow to prevent injury.
The first thing is for your child to avoid running to the bus or waiting on the street as the bus approaches. Let them know to wait away from the street and to not approach the bus until it has come to a complete stop. Once on the bus, students should be seated at all times and keep the aisles clear of all books and backpacks. Also, remind them to avoid being unnecessarily loud or from behaving in a manner that could distract the bus driver.
When getting off the bus, remind your child to walk on the sidewalk at least 5 large steps ahead of the bus before attempting to cross a street. Your child should be able to see the bus driver and the bus driver should be able to see them.
Your child staring attentively at their phones while walking to school or home is a recipe for disaster. Remind your children, especially teenagers, that it is vital that they remain alert and to avoid texting and walking with headphones on. They should also stick to the sidewalks at all times, rather that on the street, and only cross at crosswalks. Also, explain to them the dangers of horseplay while walking and warn them about making unnecessary movements into the street.
With the advent of smartphones, tablets, and other such tech gadgetry, it’s too easy for your child to become distracted. This can severely increase their risk of danger from traffic and other hazards along the way.
A heavy load on the back of a small child is an injury waiting to happen. That’s why the American Chiropractic Association recommends a backpack weigh no more than 10 percent of a child’s weight as anything above this mark can lead to back and shoulder pain as well as poor posture.
Remind your teenager to leave books at their lockers between classes and to use both shoulder straps to spread the weight out evenly.
Another great idea, if the school allows it, is to purchase your child a backpack on wheels so they don’t have to worry about lugging around an extremely heavy weight load all day.
Children and teenagers playing sports are at a higher risk of suffering from concussions. While football is commonly considered the most risky sport for physical injury, other sports such as soccer are also known to cause high rates of concussions.
If your child suffers an injury to the head, then pay close attention to symptoms of concussions which include: feeling sleepy, confusion, forgetfulness, glassy eyes, poor balance, slowed speech, or changes in behavior. If you notice any of these symptoms in your child, immediately take them to the hospital so they can be evaluated and receive proper medical care.
Teen crashes spike during the school year, especially during the hours that school begins and lets out. It’s exceedingly important that you have a conversation with your teen driver to help prevent them from hurting themselves or others on the road.
The most important rules for your teen driver to follow are:
It’s important to also remind them about safety procedures around buses. When a bus has its red overhead lights flashing, and its STOP sign out, then ALL traffic from BOTH directions must stop at least 20 feet from the school bus. Remind them to remain stopped until the flashing red lights have been turned off and the bus has begun to resume its travels.
Also, tell them to keep an eye out for pedestrians and bicyclists on the road. It’s important they give the right of way to pedestrians at crosswalks and to always focus on the road ahead. Driving recklessly with multiple passengers can lead to some very serious injuries that could have been prevented.
Of course, even the most safety conscious person can fall victim to the negligence of another. If this happens to you or a loved one, Millin & Millin PLLC will help you fight your personal injury claim. Millin & Millin PLLC is proud of our outstanding reputation and ability to successfully help clients in every imaginable type of personal injury case - especially when the insurance company is acting unethically. Give us a call at 956-631-5600 to find out how we can serve your legal needs.
Millin & Millin PLLC wishes you and your family a safe start to the school year!
Getting in a car wreck, or having a work related injury occur, can be a very trying time in your life and cause an unnecessary amount of stress to you and your loved ones. Understandably, the occurrence of such a predicament can mean an endless array of thoughts, emotions, and worries will cross your mind. However, it’s important to remain as calm and aware as possible, during the entire phase, so as to avoid mistakes that can negatively affect you, your finances, and your claims should you decide to pursue legal actions.
At Millin & Millin, PLLC our lawyers understand that every aspect of an injury needs to be thoroughly analyzed, and all medical treatments need to be fully obeyed. Ultimately though, it is the responsibility of the victim to make sure they strictly follow the guidelines recommended by their doctors so that they can effectively prove that they were injured in a particular accident.
Follow the preceding tips to ensure that you DO NOT make mistakes that can be detrimental to your case.
If you are injured in a motor vehicle accident, or another type of incident that has caused you harm, then it is essential that you do not ignore signs of pain, regardless of how “small” they may appear to be at the time. These initial signs can be indicative of a more serious injury and thus it is extremely important that you seek immediate medical attention. If you are involved in an auto accident then do not hesitate to ask for an ambulance to transport you to the hospital.
Recognize that insurance companies and juries will not rule in your favor if it appears that you were not hurt badly enough to seek immediate medical attention. See a doctor immediately and do not allow your minor injuries to get worse.
Be absolutely truthful when visiting the doctor and do not fail to mention any previous injuries or illnesses that occurred before the current situation. Supplying inaccurate information to the hospital can negatively impact the quality of care you receive and can also hurt your legal case. If you fail to provide the doctor with honest and complete information, then the defending attorneys can reject a physician’s medical opinion based on the insufficient information you provided. Do not allow a contradiction or flawed medical argument destroy your case.
The medication prescribed to you and the accompanying medical instructions need to be followed until you doctor tells you otherwise. If you are uncomfortable with the particular medication prescribed, and are afraid that there may be some unwanted side effects, then mention this to your doctor to see if they can switch you to another drug that will be just as effective. Be aware though that side effects are not rare.
Please make sure to follow the doctor’s orders as not choosing to do so can have a devastating effect on your claim.
If you have suffered a debilitating injury that has affected your range of motion or ability to function normally, you need to seek medical treatment until you are healed or your physician claims there is nothing else that can be done to improve your condition. Continue to seek support for your pain and disability until you reach maximum medical improvement.
If you stop receiving medical treatment then insurance companies can perceive that as you having healed. Even if there is a significant gap between treatments they may argue that you are seeking treatment for a new and unrelated injury. Make sure to be in continuous contact with your doctor to prove that you have consistently sought assistance.
Once an injury claim has been made, insurance companies will receive your medical records. Skipping appointments, regardless if purposely or because of legitimate reasons, will look bad on your medical records and will make it appear is if you are not committed to getting better.
Frequently skipping appointments can also irritate your doctor, and a frustrated physician doesn’t make for a good witness for their patient. If you must cancel, then be respectful and call in advance. Also, don’t forget to reschedule.
During litigation, insurance companies and juries will review your records to note how soon, and often, you reported your pain. In order to effectively have your specific pains and limitations placed on the doctor’s charts, you need to be absolutely forthcoming about your injuries. Mention how they have impacted your everyday life activities and be sure to provide specific examples - like issues with negotiating stairs or kneeling to perform your job.
Writing down this information and presenting it to your doctor can be an effective means to have them understand your needs better. Just make sure to keep a copy of what you provide the doctor and make sure your attorney gets one as well.
It is vital that you maintain proper documentation of all doctor orders, treatment referrals, and/or work restrictions. Keeping the files provided to you by healthcare providers and insurance companies will help your attorney to present an exceptional case to the insurance company. If your lawyer knows every medical care provider that you have seen, then they will be able to maximize compensation for your injuries and pain. Save those files and keep them stored in an appropriate place.
If you have any additional questions or simply need assistance with insurance claims and issues contact Millin & Millin at (956) 631-5600. Our compassion, dedication, and personal attention will get you the RESULTS you deserve.
Insurance policies can be a bit complicated, especially in their use of market terminology. To understand who is covered under your homeowner’s policy, the first thing is to know what they cover.
Most traditional homeowner’s policies cover three areas: the physical structure of your home and other buildings on the property; personal belongings; liability from physical injury endured by others as a result of your property. Usually more than just the owner of the house is protected, but not everyone is covered in all of these various areas.
Understanding what is covered, should be followed by the best practice of doing a thorough reading of your insurance policy to ensure what you have purchased will meet your needs, and to also develop a better understanding of who is insured under your homeowner’s insurance.
Unfortunately, it’s quite easy to get lost in the insurance jargon we often find in our policies and this can lead to some major issues when we need to make a claim. If you are having problems with your insurance company as a result of bad faith policies and are facing anxiety, as well as expense issues, then contact Millin & Millin Attorneys who can even the playing field against your insurance provider. They may not always act in your best interests, but Millin & Millin Attorneys will.
Here are some of the individuals that should be insured under a “common” policy.
Every policy will list a named insured, “You”, which is policy-wide term; if the house is owned jointly, both names should be listed. This individual is the primary insured and benefits from the most coverage that includes the three areas mentioned above - property, personal property, and liability. The name insured tends to be the same person listed on the house deed, and whenever there is damage to the house, will be the one to make the claim.
Even if they are not specifically identified in the policy, as long as your spouse resides in the house, they are under the personal property and liability coverage.
Any individual who lives in the residency are covered by personal and liability insurance including: children; an aging parent; resident non-relatives under the care of “You” and who are under 21 years of age; student enrolled full time who was a resident prior to attending school and is under age of 24 if related to “You”; children who have returned back after graduating college even if over the age of 21. Check with your insurance agent for a more detailed list of who would be considered a resident.
Any individuals who are employed by the owner of the house, such as a housekeeper, are only covered by the personal property provision. Options, such as the employment practices liability insurance (EPLI), can provide protection against a variety of risks such as wage/hour defense, harassment/discrimination, or wrongful termination.
Guests and invited visitors are only covered for personal property insurance if that coverage is requested at the time you purchase the policy.
Renters are generally NOT covered by your insurance policy. In most cases, tenants will need to purchase their own renter’s insurance to protect their belongings in case your property is damaged or vandalized. This policy can also provide protection from being liable in case of an injury or property damage.
You may be interested in purchasing specifically designed rental property as standard homeowner’s insurance may not adequately cover liabilities.
These rules and policies are set in place to protect you and your loved ones from the financial burden of accidents and catastrophes that can strike at any moment. Sadly, insurance companies don’t always seek to treat you fairly. That’s why Millin & Millin Attorneys is here help.
Our track record of successful litigation against the disreputable actions of insurance companies is one of the reasons we continue to grow. Find out how we can secure you fair compensation on your insurance policies by scheduling an appointment with us today.
Making an insurance claim on a motor vehicle accident, construction issue, or personal injury incident, can be outright confusing; especially if it’s your first time going through the process.
Don’t worry though. Millin & Millin PLLC are more than capable of advocating for you and helping you find the peace and justice you deserve. When you choose Millin & Millin PLLC, you are never alone in the process.
In fact, here are some tips and information that will help to ease the stress of going through the various steps of the claim.
The first thing we advise you to do is to read through your insurance policy thoroughly to see whether you are covered and what exactly you are covered for. Bare in mind, you may be covered for the same loss under more than one policy. However, you cannot claim under more than one policy for any loss, so carefully consider which policy to claim against.
If you need to set up an insurance claim, call your insurance adjuster and provide them with exact and concise details of the claim. Also, make sure to request a claim form if they have not offered to give you one.
Depending on the specific type of claim, your insurance adjuster will give you advice on what to do next.
For example, if your home has been damaged, they may suggest you get some emergency repairs done. Always check that your insurance will cover the cost of any repairs. For larger claims with extensive damage to the home, it may be best to hire an experienced professional to thoroughly inspect the area.
By working with a 3rd party inspector, you’ll have a professional working on your behalf (rather than for the insurance company), and they may even help to negotiate with your insurance company to settle your claim. By utilizing an expert, insurance companies are much more liable to provide you with the proper compensation for the damage to your home.
However, keep in mind that the inspector will not be covered by the insurance, and you will have to pay for their fees out of pocket.
Another aspect to take into consideration is the “size” of the claim. If the total amount is relatively insignificant, then you might want to hold back on making that claim.
If you do decide to make a claim, regardless of its monetary value, you may lose your no-claims discount with certain insurance companies. A no-claims discount takes into consideration the number of years in which you have not made a claim on your insurance policy and its worth varies from insurer to insurer.
Additionally, you may find it more difficult to shop around for certain types of coverage the next time you renew your policy.
Furthermore, insurance companies are required by law to have a written procedure in place for dealing with claims and should assist you in the process. You should also consistently receive information about new developments and about changes within the process that can affect the outcome of your claim.
You should know the decision on your claim within 10 business days of when the insurance company makes the final decision.
When a claim is not settled in your favor, you should receive the reasons why in writing, and be provided with details on how you can appeal the decision. There is no definite length of time to settle an insurance claim and it simply depends on the type of claim being made. Complicated or larger claims may require expert analysis or the input of several knowledgeable professionals before the claim can be decided.
Though your insurance company will be the party that decides whether your policy covers the costs and damages, ultimately it is your choice whether or not to accept the settlement. If you are dissatisfied with their offer then you have the legal right to attempt to negotiate. If the statute of limitations has not passed, then you are allowed to seek legal advice, and have an attorney review your case to help you determine if are being compensated appropriately.
Make sure to always give accurate information whenever you are applying for an insurance policy. Be aware that any claim you make could be negatively affected if you give inaccurate or incomplete information when you initially apply.
If you have a claim against you by another party, insurance companies are not obligated to inform you of the outcome of such a claim and can agree upon a settlement without your knowledge or consent.
Always keep in contact with your insurance company and know the name of the insurance adjuster who is appointed to your case. If you disagree with the outcome of claim against you or have any issues throughout the process, you have the right to let your insurance adjuster know, and can speak with a representative from the customer service department at the insurance agency.
If you were involved in an auto accident, or perhaps affected by hail, and need repairs made to your car, you might want to make a claim on your policy to cover the cost.
Your insurance company will likely have a list of approved auto repair shops that are permitted to work on your vehicle. There is also the possibility that you may be given the option to use an auto repair shop of your choice.
