Insurance Law

Insurance Law Pittsburgh, PA

Insurance LawEveryone eventually has dealings with an insurance company, and at times these dealings end in disappointment, and in some cases, litigation. Unfortunately individuals may need an attorney’s services to get an insurance company to comply with its obligations.

Insurance policies are very complex documents, and while a great many claims are settled without difficulty, there are those that may have a questionable outcome. Especially complicated are some claims involving home owner’s insurance, where the cost of replacing property destroyed in a fire, for example, or providing shelter for a displaced family can run into thousands of dollars. All too often individuals fail to understand the basics of their insurance policies, or may think they are adequately insured when they are not. An attorney’s advice when selecting insurance policies covering valuable property can be well worth a consultation fee. If an individual is denied coverage, an attorney can assist in discovering why coverage was denied.

If coverage is unfairly denied under a policy where the policy holder believes that he has a right to coverage, a bad faith litigation claim can be brought against the company. In a case where an insurance agent offers poor advice to client, recommends inadequate coverage or does not inform the policy owner of changes in coverage, an insurance agent negligence claim may be brought.

Unfortunately, insurance fraud is not uncommon, and insurance companies are on the alert to discover if an insured may be attempting to make a fraudulent claim. In Pennsylvania, insurance fraud is a felony. Automobile insurance fraud is not infrequent: exaggerating damage to a vehicle or having a repair shop inflate a bill to cover a deductible is common. Health insurance fraud, including Medicare fraud, runs into billions of dollars a year. Unscrupulous doctors may inflate bills or bill for services never performed. Worker’s Compensation fraud occurs when a worker overstates an injury, or claims an injury happened on the job when it occurred elsewhere, or if a worker takes another job while collecting compensation . Understating payroll to avoid higher premiums or failing to carry insurance is a type of fraud committed by an employer. A fraud may be committed to collect on homeowner’s insurance when the homeowner overstates property damage, has a contractor “pad” a bill, or an individual stages a burglary to collect for property supposedly stolen.

For the above reasons, an insurance company may require the insured person to be examined under oath. In addition, a client may make false statements on an application as well as claiming a loss that is not legitimate. The examination may take place at the office of the insurance company’s attorney or at the office of the attorney of the insured. In either case it is important to have legal representation.

It is a cardinal rule that every insured should understand all the ramifications of his insurance policy and should avoid even the semblance of dishonesty when dealing with an insurance company. If an individual feels that he is being dealt with unfairly and has not been able to reach a settlement, legal advice is essential.

DISCLAIMER: The materials contained on this web site are provided for information only and do not constitute legal advice. Contact with this web site does not establish an attorney-client relationship.