Court of Appeals Clarifies Policy Causation Language In Favor Of The Insured

When language in one part of your ERISA policy says your claim is covered, can the company rely on language elsewhere in the policy to deny your claim?  The Ninth Circuit Court of Appeals recently answered “no.”  In Dowdy v. Metropolitan Life Ins. Co., the court ruled the conflicting language about what caused the insured's …

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Insurance Coverage Uncertain for Hawaii Homeowners After Volcanic Eruption

Hawaii homeowners who incurred damage or lost their homes entirely now face uncertainty over whether their insurance will cover the damage.  The Seattle Times recently interviewed several Hawaii residents who expressed concern over whether they will have any coverage.  The eruption has so far destroyed about two dozen homes on Hawaii's Big Island.  Authorities reported …

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Can The Company Deny Your ERISA Claim “Because We Said So?”

Who decides whether a person’s entitled to coverage under an ERISA plan?  Given ERISA gives plan participants the right to take the company to court to dispute coverage denials, you might think the judge decides.  But the answer’s not that simple.  Often, the insurer itself can decide whether you’re covered under the terms of the …

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How Will Insurance Cover Self-Driving Cars?

Self-driving vehicles are already on roads in several cities and are predicted to become normal in the next few decades.  How will your insurance cover you if you’re the operator of a self-driving car? If someone else’s self-driving car injures you or damages your property, will the owner have coverage for your loss? The Badlands, …

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Why Won’t Your Government-Mandated Flood Insurance Pay Your Claims?

CBS’ recent investigation found the federal National Flood Insurance Program (“NFIP”), intended to benefit homeowners caught in flood disasters, actually winds up paying most of its money to help insurers avoid paying claims. The problem is NFIP doesn’t pay flood victims directly.  Instead, NFIP collects premiums and taxpayer dollars, then turns the money over to …

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Washington Federal Court Rejects Insurer Efforts to Escape Lawsuit by Paying Benefits Retroactively

One important right policyholders have is to be fully compensated or "made whole" when the insurer improperly denies coverage or payment of benefits.  Some insurers argue, incorrectly, that they can avoid making the policyholder whole by paying the disputed policy benefit after the policyholder files a lawsuit.  That's incorrect because by the time the policyholder …

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Court Rules School Buses are Not “Automobiles” Under State Farm Insurance Policy Fine Print

Whether a school bus is an automobile would seem to be a matter of common sense.  Unfortunately for the policyholder in one recent lawsuit, it's actually a matter of reading the fine print. Washington’s Court of Appeals recently issued a ruling that significantly limits policyholders’ coverage under many automobile insurance policies. In Koren v. State …

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