New Jersey Insurance Coverage Attorneys

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Insurance Coverage in New Jersey

1. Do you know what insurance plan you purchased? / Is your insurance policy’s coverage different from the coverage you were told you would have?

When selling insurance plans, sales people describe their carrier’s insurance coverage in several ways. Insurance firms use ads, “summaries,” lists, brochures, and other writings they directly, or via their brokers, provide you to describe the claims they will compensate or protection their policies provide.

Sometimes the ads, summaries, lists or leaflets describe things that they will pay for, when in fact the insurance policy you are mailed, often months after you buy it, is not going to take care of or pay for issues discussed in the summaries, lists and advertisements.

Given that insurance policies are hardly ever sold by giving you the policy, before you buy it, have an agent or sales person explain what you actually bought, insurance plans often have upsetting surprises based on protection that is different from what you were guaranteed or told you were purchasing.

2. Does your policy contain illegal provisions?

In addition to supplying individuals policies which are different from what they were told they were buying, insurance companies occasionally write their insurance policies in violation of state laws. States restrict specific exclusions and coverage restrictions, yet when an insurance company sells plans in several states there have been situations where their multi-state plan violates the laws of some of the states where it is sold.

3. Has your health insurer mis-categorized your treatment and thereby eliminated your coverage?

When it comes to medical health insurance, an insurance policy commonly describes what medical care or treatments are included, but it does not usually describe all possible treatments, illnesses or conditions. The medical industry relies on a coding system to describe patient treatment. The codes are linked to whether or not, how much and for how long a health insurer will cover treatment. Through erroneous or questionable coding of your condition, illness or treatment, you can lose your coverage or have it restricted.

4. Property Insurance: If there are covered and non-covered factors to eliminate or replace a part of your home or building, which did your insurer pick?

The need to remove drywall, tile, natural rocks, or to test out heating or air conditioning equipment could possibly be because of a non-covered cause or because of covered cause. Has your provider ignored the covered cause and just flat-out denied your lawsuit? You might need experienced coverage attorneys to review your policy to sort out the morass of coverages, exclusions and definitions which have to be pieced together to truthfully determine whether your loss is covered.

5. Were you made aware when signing up for insurance that you’d be given a “short rate” refund (in reality a penalty) in the event you cancelled the insurance policy prior to the end of the plan term?; were you made aware of your insurance company’s “short rate” refund policy when you purchased your insurance policy?; were you made aware of the your insurance company’s “short rate” refund policy when you called to cancel your policy?

New Jersey Protection Against Short Rate Fees

A “short rate” is the insurance premium price an insurance company bills you when you cancel your policy before it ends. While many insurance companies go back to their insureds the pro-rated unused percentage of the premium, a small group of insurance firms charge their coverage holders a fine for terminating their policy before its expiration. Those company’s reimburse only the short rate unused portion of the insured’s premium. Farmers’ failed to notify the insured that contacted Eppsteiner & Fiorica at the time it sold the policy, when it sent renewal notices, when the insured terminated his plan, nor even then they sent him his policy reimbursement that they were just paying him a “short rate” refund. Isn’t this conduct fraudulent, misleading and based on withholding material information? Eppsteiner & Fiorica is presently looking into the practices of Farmers Insurance, who has been brought to our attention by a customer who claims they were not told they would only be paid a “short rate” refund when he terminated his policy. Please continue for more details pertaining to this investigation.

At Eppsteiner & Fiorica, our experience is that insurance companies generally do not translate insurance policies fairly or to favor you. Sometimes you can determine arguments with your insurance provider. However, too often you will need a lawyer with expertise and experience in insurance coverage issues who can sort out the tangle of provisions, exclusions and definitions, and put together the pieces needed to perfect your insurance coverage and get your claim paid. When you can’t get a good coverage solution worked-out on your own and need legal advice and a lawyer:

• Call our California or Colorado law office at 866-548-8857
• E-mail us at solutions@eppsteiner.com
• Click here to contact