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Insurance company representatives use many different tools and marketing materials to sell their policies. These usually include pre-printed advertisements and brochures, as well as lists and summaries of the coverage options available. This is how policies are presented to potential policyholders – in advertising pieces instead of in a form that reflects what is actually in the policy.
Once you agree to a policy that meets your needs and sign on with the company, they send you a copy of the policy through the mail. This process can take several months, meaning there is time to forget what your selected policy covers and what its exclusions are before you have a chance to review the policy. In addition, many policyholders never review their insurance protection policy once it is received. After all, you agreed on the list of coverage included in their marketing materials, right?
Many Illinois policyholders find their policies don’t reflect the provisions and exclusions they agreed to after careful review.
Some insurance companies use a generic policy to cover several states, instead of a policy customized for each states insurance coverage regulations. This is an issue because state laws determine what exclusions and provisions are allowed and which are prohibited. This means that you may be paying for coverage that you will never receive because it is illegal in Illinois. The same may be true if you live in any other state. Attorneys who are well versed in insurance law can help you determine what you can expect from your policy in Illinois.
The health care industry uses a coding system to let insurance companies know what procedures and treatments their policyholders are receiving. The insurance companies then compare these codes to your policy provisions, and determine how much and for how long they will cover your treatment. Some codes are not covered by your policy at all.
An error in this coding, usually an accidental typing mistake by the coder, can cost you thousands of dollars out of pocket for the treatment and can even cause your insurance company to drop your coverage.
Most property insurance policies replace or repair property only under very specific circumstances. If the damage to your home occurs through the result of both covered and non-covered clauses, your insurance company could deny your claim out right. This means you could be paying for replacing drywall and tile or even rebuilding your home without your insurance company paying you a dime.
When these situations occur, policyholders often have to resort to hiring lawyers well versed in insurance protection to ensure they are paid according to their policy provisions.
Most insurance companies simply refund the percentage of your pre-paid premium that would have covered the months after you cancel your policy. Other companies, however, have penalties called short rate refunds. This practice of fining the policyholder for cancelling is legal, but the insurance company must notify the customer of the policy.
Companies who use short rate refunds methods keep a percentage of the pre-paid premium instead of refunding the full, unused amount. Eppsteiner&Fiorica are currently investigating at least one case of an insurance company who did not notify policyholders of this practice in advance.
The client was a policyholder for Farmers’ Insurance. After cancellation, they received a short rate refund. They were not made aware of this practice during the policy selection process, in writing in the policy, in renewal notices or even during the communications about cancellation. In fact, even when the short rate refund was sent to the client, there was no mention why it was not for the full amount.
To most people, this seems misleading, if not fraudulent. Eppsteiner&Fiorica continues to investigate this case, and will have more information forthcoming.
As a law firm specializing in insurance coverage matters, Eppsteiner&Fiorica has a vantage point of insurance companies that few will ever have. We have seen case after case where the companies do not treat policyholders honestly or fairly. In many cases, policyholders work out their issues without legal assistance. Too often, though, attorneys must be called upon to ensure policyholders receive the coverage they have paid for.
If it comes to this point in your dispute with your insurance company, Eppsteiner&Fiorica have the experience and the expertise necessary to determine the provisions and exclusions described in your policy and fight for your fair settlement:
“We were a small group of homeowners sharing a common problem – leaking, moldy windows. After the window manufacturer refused to help, we retained Stuart Eppsteiner to pursue legal action. Stuart and his team discovered the causes of the window ... Read More...
“We had problems with the windows in our house. Stuart took charge of things, had experts figure out what was wrong, filed suit and settled the case with a great result. Stuart was available to me during the lawsuit and ... Read More...
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