Know Your Rights – Long Term Care Insurance

Many people have long term care insurance, especially when they get older, because the cost of prolonged individual care due to an injury or illness can be significant.  For that reason, Long Term Care insurance is often part of people's estate plan. Long Term Care insurance can be subject to problems because the premiums get …

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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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Aetna Fined Over Autism And Substance Abuse Coverage

State regulators in Pennsylvania fined health insurer Aetna  this week, for violating rules on coverage of drug and alcohol abuse treatment and coverage of autism spectrum disorder. A federal law called the Mental Health Parity and Addiction Equity Act generally forbids health carriers from discriminating against coverage for mental health conditions or substance abuse disorders.  …

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Happy New Year – Washington Health Insurers Are Now Required to Expand Contraceptive Coverage

In 2019, Washington health insurers are required to expand contraceptive coverage. Any health plan in Washington issued or renewed on or after Jan. 1 must now provide coverage for the following: All FDA-approved contraceptives, including drugs and devices; and Voluntary sterilization procedures. The new law also requires coverage for consultations, examinations and procedures necessary to obtain …

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Court Ruling Emphasizes Common Sense Reading of Insurance Policy in Win for Policyholder

The Washington Court of Appeals recently decided Poole v. State Farm Fire and Casualty Company, a case about fine print in a homeowner's policy.  After the Pooles' home burned down, State Farm denied coverage under a technical reading of the words "similar construction."  Washington's Court of Appeals disagreed with State Farm and emphasized the traditional …

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