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Pennsylvania Insurance Coverage Attorneys


Insurance Coverage in Pennsylvania

  1. Are you aware of what insurance coverage you have? Does your insurance policy’s coverage vary from what you were advised that you would receive?
  2. Salespeople explain their carrier’s policies in many different ways while selling insurance policies. Insurance companies use “summaries,” lists, advertisements, leaflets, and other various writings that they present directly or via their agents. All such literature purports to describe the type of claims they honor and specific coverage their policies include.

    Quite often, the summaries, leaflets, advertisements, or lists outline things the company will pay for when in fact, the policy you actually receive does not include or provide benefits for matters set forth in the lists, advertisements, and summaries.

    Insurance coverage is rarely sold by presenting you with the actual policy prior to you buying it. Therefore, you should have the sales rep or agent describe in detail exactly what you have actually purchased. Insurance policies frequently have unpleasant surprises that stem from coverage, which is entirely different, from what you were promised or told that you were buying.

  3. Does your insurance policy have illegal provisions?
  4. In addition to issuing policies that vary from what buyers were initially told they were receiving, insurance carriers sometimes write their policies in a manner that violates state laws. State statutes prohibit certain coverage restrictions and exclusions. When an insurer sells plans in several different states, however, scenarios have developed wherein their multistate coverage violates the laws of some states in which they are sold.

  5. Has your health insurance carrier mis-classified your treatment and thereby eliminated your insurance protection?
  6. In the medical health insurance realm, policies typically describe specific medical care or treatments that are covered. They do not typically describe every possible treatment, condition, or ailment, however. The healthcare industry utilizes a coding system to describe specific treatments. The codes are connected to whether or not, how long, and how much an insurer will pay for a given treatment. You can lose your health insurance coverage or have it become constrained due to questionable or erroneous coding of your illness, condition, or treatment.

  7. Property Insurance: If both covered and non-covered motives for removing or replacing part of your structure exist, which ones did your insurer choose?
  8. Having to remove tile, drywall, and natural rocks, or test heating and air conditioning equipment may be due to a non-covered cause or a covered cause. Did your insurer overlook the covered cause and simply deny your claim? You may need the assistance of competent insurance coverage lawyers to analyze your policy in order to sort through the maze of coverage, definitions, and exclusions that must be truthfully pieced together to determine whether you have sustained a protected loss.

  9. Where you advised when initially signing up for insurance coverage that you would receive a “short rate” refund if you terminated the policy prior to its plan term end date? Did the agent explain the insurer’s “short rate” refund policy at the time you bought your coverage? Were you made aware of your insurance carrier’s “short rate” refund policy when you inquired about terminating your policy?

Pennsylvania Short Rate Premium Costs

A “short rate” is the premium rate that the insurance company charges you in the event that you terminate your policy before its expiration date. Many insurers refund a prorated amount of the unused premium. A few insurance companies charge their policyholders a fine for early policy termination, however. These companies refund the short rate unused portion of an insured’s premiums. For instance, Farmers Insurance Company failed to notify an insured that subsequently contacted Eppsteiner Law, APC at time of policy sale, upon sending renewal notices, when the policyholder ended his coverage, or even when they sent him a plan reimbursement that he was receiving a “short rate” reimbursement. Such misconduct definitely constitutes a deceptive trade practice by misleading a customer by withholding pertinent information. Eppsteiner Law, APC is presently investigating Farmers’ Insurance procedures because a client stated that they were not advised that they would receive only a “short rate” refund upon policy cancellation.

It has been our experience at Eppsteiner Law, APC that insurers frequently fail to interpret policy provisions fairly or in a manner that favors the insured. Quite often, you may devise arguments against your insurance carrier’s position. Even so, you will frequently need knowledgeable insurance coverage lawyers experienced in such issues. These professionals are capable of sorting out the various policy exclusions, definitions, and provisions to put the pieces together in order to perfect your insurance contract and obtain recovery on your behalf. If you cannot obtain a satisfactory coverage solution by yourself and want competent legal advice from one of our qualified insurance protection attorneys:



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