Can the Insurance Company Retroactively Deny Your Claim On A New Basis After You File A Lawsuit?

Let's say you make an insurance claim, and the insurance company denies the claim for reason A.  You think they're wrong, so you take them to court and argue reason A is invalid and the company should have paid your claim.  In response, the insurance company admits reason A didn't apply but now argues your …

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Do I Have To Cooperate With My Insurer After A Loss?

Imagine your house catches fire and you make a claim for coverage under your homeowner's insurance policy.  After a few weeks, the insurer denies the claim.  They don't dispute the fire happened.  But they say they don't have to cover the damage because you didn't cooperate with their investigation.  They claim you should have sent …

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Can The Insurance Company Cancel My Policy For Late Premiums?

It's fairly easy to miss an insurance premium payment.  You buy your policy online, set up monthly auto pay through your debit card, and forget about it.  But then you have to replace your card, or get a new card number or bank, or the account is overdrawn, or something else happens.  Or, maybe you're …

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Washington Court of Appeals Emphasizes Insurers May Not Categorically Ignore Their Insureds’ Treating Physicians When Deciding Whether Injuries Are Covered

Shannon Leahy found herself in a common situation when dealing with her auto insurer following a car crash.  Her insurer agreed she was not at fault, but refused to pay her claim, arguing her medical treatment was unrelated to the crash.  Ms. Leahy’s doctors agreed her treatment was related to the crash, but State Farm …

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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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