According to the law, ambiguous insurance policy provisions are to be interpreted in favor of the policyholder and against the insurance company. Too often, insurance adjusters do just the opposite and deny coverage based on ambiguous policy provisions.
Insurance policies are contracts between the insurance company and the policyholder. Insurance companies draft the language of
Insurance adjusters often don’t know how to properly interpret the language of the very insurance policies their companies sell their policyholders. My experience tells me adjusters often read the insurance policy looking for any arguable as (even outlandish) way to deny coverage. They take language out of context, misapply language to the facts of the
When an insurance company receives a claim from its policyholder, the first thing the adjuster does is “check coverage.” This means they verify the policy is in force by making sure the premiums have been paid and the policy period is in effect. Then, the adjuster looks at the facts of the claim the policyholder
As discussed in previous posts, an insurance company violates the duty of good faith and fair dealing when it attempts to alter the terms of its policy bargain with the policyholder by attempting to use its claim department as a profit center.
How does an insurance company get its claim personnel to buy in to
As discussed in my last post, insurance companies (not policyholders) gamble when an insurance policy is issued. The insurance company takes on the risk of paying claims under the policy in exchange for the policyholder’s premium. The policyholder does the opposite of gambling. She does away with (or at least protects against) the risk of
As discussed in earlier posts, insurance is not a gamble taken by a policyholder. Instead, the policyholder buys insurance to protect himself from the risk of a loss, whether it be a medical bill, damage to the policyholder’s property, an untimely death or a liability claim made against the policyholder by a third party. The
Most of us define insurance by what it does for us under the policies we have purchased. If asked “what is insurance?,” most people would say “it pays for damage to my car” or “it pays my medical bills if I get sick” or something to that effect. These are good working definitions, but a