3 Situations When You Will Need an Insurance Attorney by Your Side
Taking out an insurance policy is all about getting more peace of mind. You might want to insure your home, property, vehicle, or health by taking out insurance that protects those assets against a possible accident.
In essence, insurance revolves around transferring the risk of a possible loss from yourself and your family to the insurance company. You pay your monthly premiums to an insurance company and the insurance company, in turn, remunerates you for a loss following an accident.
You sign a contract with an insurance company that you're going to be acting in utmost good faith, which is a common law term that essentially outlines your legal obligation to honestly file an insurance claim. Accidents are simply a part of life: That's why insurance is around to protect you.
As it happens, the insurance company also has a contractual obligation to act in good faith too. Just as the person with the insurance policy can't make fraudulent claims, the insurance company can't unfairly deny coverage. Being fair is what "good faith" is all about.
First-Party Coverage Versus Third-party Coverage
The difference between first-party coverage and third-party insurance coverage might sound complicated but the basics are pretty easy to understand. One's not better than the other but they are different.
Essentially, first-party coverage helps insure you against damages you personally suffer - e.g., property insurance protecting your home after a tornado or a health insurance policy protecting you after a medical emergency.
Third-party coverage, on the other hand, covers damage that you may have caused another party. The most common type of third-party coverage involves auto coverage—imagine a case in which you damage another person's car, or an auto accident that you caused resulted in personal injury to someone else.
If you need further clarification about the insurance company's role following an accident or lawsuit, then you absolutely need to get in contact with an insurance attorney who can walk you through the basics.
There might even be a ticking clock in that you could be required to submit a sworn statement of loss by a certain date or provide bills to an insurance adjuster within a set timeframe. An insurance attorney can make sure you understand your insurance policy and your legal responsibilities.
An insurance attorney might be required if you're injured on the job and your employer insists that you're not covered by workers' compensation.
Workers' compensation is a form of insurance that potentially replaces your wages and covers your medical expenses if you get injured on the job. Contact an insurance attorney to learn more.
Uncovered Medical Expenses
You should get in contact with an insurance attorney immediately if you're facing huge medical expenses and your ACA health insurance carrier is refusing to cover your medical bills.
Provided you've been paying your health insurance premiums on time and you've met your deductible, there's a good chance that you're done everything in your power to ensure coverage.
An insurance attorney can work with you to find out whether your health insurer was acting in good faith or violating "good faith" and "fair dealing" when your insurer denied you coverage.
An insurance contract has an "implied covenant of good faith and fair dealing," which means that both parties (i.e., you and your health insurer) have agreed to deal with each other honestly and in good faith.
If you feel like your health insurer hasn't lived up to their end of the bargain, then contact an insurance attorney immediately to discuss your options moving forward.
Even if your life insurance claims are being denied, you may have more options than you think.
An Automobile Accident
Automobile accidents can be complicated because they can deal with both first- and third-party insurance claims. You might even need the help of an insurance attorney who also specializes in personal injury in some cases.
Suppose you injured another motorist through an accident. Also imagine that the motorist you injured is uninsured or that you were also injured in the accident.
Determining your liability, the liability of the other motorist, and the insurer's liability can get complicated in a hurry, and you might need an insurance attorney to help figure things out.