Getting What You Pay For With Your Insurance Premiums

People frustrated dealing with their insurance company often wonder what they've been buying when they paid premiums for all those years. Insurance premiums buy you a whole host of benefits beyond just the possibility the insurer might someday pay you for a covered loss. Insurance premiums buy you the promise of peace of mind and …

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Court Ruling Emphasizes Tie Goes to the Policyholder When Interpreting Insurance Policies

Washington insurance law includes a principle that if an insurance policy is ambiguous, i.e., if it can reasonably be read in multiple ways, the court will adopt the reading that is most favorable to the policyholder.  This rule exists because insurance companies are sophisticated enough to draft their insurance policies the way they want, and …

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Know Your Rights – ERISA Claim Deadlines

We've previously blogged about the importance of meeting deadlines in your claim for benefits under an ERISA-governed insurance policy.  Most ERISA plans have strict deadlines for submitting a claim, appealing the insurance company's denial of your claim, and filing a lawsuit.  The deadlines are strict and ERISA is draconian about deadlines - missing them by …

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ERISA Plans Can’t Discriminate Against Domestic Partners, Court Rules

In Washington, and many other states, domestic partners enjoy the same rights and legal protections as spouses.  The Ninth Circuit Court of Appeals recently confirmed that domestic partnerships' equal treatment under state law extends to ERISA plans. ERISA plans typically give the plan administrator broad discretion to interpret the terms of the plan.  This often …

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Washington State Bans Surprise Medical Billing

We previously blogged about the push by Washington's Insurance Commissioner to ban so-called surprise medical billing, i.e., where an insured gets hit with a huge bill for medical treatment despite going to an in-network provider or seeking emergency care.  In those circumstances, the insurer claims the hospital's bill is too high and refuses to pay, …

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