Insurance and ERISA Legal Issues Around Puget Sound
Let's say you go to an insurance agent to buy an insurance policy. You tell the agent you want coverage for something specific, for example, fire damage to your boat. The agent sells you a policy the agent tells you covers fire damage to your boat. The agent gives you some documents summarizing the policy …
Continue reading WA Supreme Court Confirms Insurers Must Follow Their Agents’ Promises
On October 3, 2019, the Washington Supreme Court decided Strauss v. Premera Blue Cross, holding the Strausses could sue Premera Blue Cross for denying coverage for Proton Beam Therapy to treat prostate cancer. Mr. Strauss had a Premera health insurance policy. The policy promised Premera would pay for “medically necessary” treatment. Mr. Strauss was diagnosed …
Preliminary reports suggest Washington State's Affordable Care Act (a/k/a Obamacare) plans will see minimal rate increases in 2020. Washington State exchange plans are projected to see a 1% average rate increase, lower than almost half of other states in the U.S. Washington's Insurance Commissioner reportedly credited Washington-based health plans with the low increases. Washington-based insurers …
Let's say you become ill and can't work anymore. Fortunately, you have disability insurance coverage through your employer. You apply and get awarded benefits. The policy says your benefits are two thirds of your salary. But the insurance company is paying you less. They say that they can subtract from your benefits any money you …
Let's say the insurance company denies your claim. They don't dispute you had a covered loss, but they say you missed a deadline buried in your insurance policy requiring you to notify them of the claim within a certain time. Can they do that? The answer, often, is no. But the devil's in the details. Virtually …
Continue reading When is it “too late” to make an insurance claim?
