New York Insurance Coverage Attorneys

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Insurance Coverage across New York

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

When selling insurance policies, sales people illustrate their carrier’s policies in several ways. Insurance firms use ads, “summaries,” lists, flyers, and other writings they directly, or by means of their agents, give you to describe the lawsuits they will pay or coverage their policies provide.

At times the advertisements, summaries, lists or brochures describe things that they will cover, when in fact the insurance policy that you are mailed, generally months after you purchase it, does not include or pay for factors discussed in the summaries, lists and advertisements.

Given that insurance is hardly ever sold by giving you the policy, before you purchase it, have an agent or sales rep describe what you actually bought, insurance policies usually have upsetting surprises based on protection that is different from what you were guaranteed or told you were getting.

2. Does your policy contain illegal provisions?

Along with giving clients policies that are different from what they were instructed they were buying, insurance companies occasionally write their insurance policies in violation of state laws. States forbid certain exclusions and policy restrictions, yet when an insurance company sells plans in many states there have been scenarios 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 therefore eliminated your coverage?

When it comes to health insurance, an insurance policy commonly describes what medical care or treatments are covered, but it doesn’t usually describe all possible treatments, ailments or conditions. The health care industry uses 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 ailment, illness or treatment, you could lose your coverage or get it restricted.

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

The need to remove drywall, tile, natural rocks, or to test out heating or air conditioning equipment might be because of a non-covered cause or because of covered cause. Has your carrier ignored the covered cause and simply flat-out denied your claim? You might need experienced coverage lawyers to review your policy to sort out the morass of coverages, exclusions and definitions which have to be pieced together to honestly determine whether your damage is covered.

5. Were you made aware when signing up for insurance coverage that you would be given a “short rate” reimbursement (in truth a penalty) if you cancelled the policy prior to the end of the plan term?; were you made aware of your insurance company’s “short rate” refund policy when you bought your insurance policy?; were you made aware of the your insurance company’s “short rate” refund policy once you called to terminate your policy?

New York Short Rate Protection

A “short rate” is the insurance premium fee an insurance company bills you if 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 companies charge their coverage holders a penalty for terminating their coverage before its conclusion. Those company’s reimburse only the short rate unused part of the insured’s premium. Farmers’ did not inform the insured that contacted Eppsteiner & Fiorica at the time it sold the policy, when it mailed renewal notices, when the insured ended his coverage, nor even then they mailed him his policy reimbursement that they were just paying him a “short rate” reimbursement. Isn’t this conduct fraudulent, misleading and dependent on withholding material information? Eppsteiner & Fiorica is currently looking into the procedures of Farmers Insurance, who has been brought to our attention by a customer who states they were not informed they would only be paid a “short rate” refund when he ended his coverage. Please continue for more information relating to this investigation.

At Eppsteiner & Fiorica, our experience is that insurance providers typically do not interpret policies fairly or to favor you. Occasionally you can work out arguments with your insurance company. However, all 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. If you are unable to get a good coverage solution worked-out on your own and need legal advice and a lawyer:

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