Many people in Austin have faced health challenges over the past year and a half, leading to costly medical bills. While they may be grateful that they have health insurance to cover these expenses, the fact is that sometimes a health insurance claim is denied. The...
When Texas drivers take to the road, they most likely are not thinking about each and every risk associated with driving. While most motorists drive safely on the roadways, this does not rid the roads of accidents. Thus, when an automobile collision occurs, a motorist...
You’ve been diligent in paying your insurance premiums to ensure that you can have access to affordable healthcare when needed. Then, the moment comes when you have to rely on that insurance policy to prevent yourself from falling into financial ruin. The only other...
Medical care out-of-pocket is expensive, which is why most Texas residents pay for health insurance to cover the majority of their cost. When they pay for a procedure, most people expect to be reimbursed by their insurance company. Unfortunately, some people have to...
The need for long-term care in our country is astounding. Some estimates put the rate at 60%, with 40% of elderly individuals needing some sort of nursing home or assisted living care. That’s why decades ago long-term care policies were extremely popular. These...
The Texas ice storms were a shock to people who believed the state was shielded from such dramatic weather events. For many, it also highlighted how their insurance policy coverage might not be as extensive as they initially thought. Compounding a terrible occurrence...
While many states in the U.S. require motorists to carry auto insurance, the fact of the matter is that some people do not. According to the Insurance Research Council, approximately one in eight motorists do not have an auto insurance policy. So, what happens if you...
Ever since you started driving, you likely had auto insurance. Like most people, you probably pay for this insurance to protect your interests in the event of a car accident you cause or another person causes. According to the Insurance Information Institute, people...
Many employees in Texas receive benefits, such as health insurance, from their employers. Thus, when issues arise related to their health insurance claims, this may cause an employee to question whether he or she could file an action to ensure his or her rights are...
Texans are unaccustomed to anything more than brief and passing cold temperatures and harsh winter weather. Homes are often unprepared for the aftermath of snow, ice and freezing temperatures. This can result in damage and the need to file insurance claims to pay for...
Long-term disability can be a strain on many individuals and families in Texas. It is helpful for those making a long-term disability insurance claim or appeal to understand the overall impact of long-term disabilities which they may be experiencing on a daily basis....
Uninsured motorist coverage can be important to anyone hit and harmed by an uninsured or underinsured motorist. Specifically, victims should be familiar with what uninsured motorist coverage can help with following a car accident. What does uninsured motorist coverage...
Your insurance company has no problem collecting the premiums you pay regularly. When you need to file a claim, your insurer should pay the claim promptly according to the terms of your policy. If that does not happen, your insurance provider may not be living up to...
Motor vehicle accidents are stressful for victims, no matter how serious they are. From a fender-bender to a life-threatening crash, an accident can create confusion, fear, and anxiety in the life of a victim. When a vehicle accident happens in Texas, a victim can...
When we think of our major assets, we might think of our house, automobiles, jewelry and other tangible assets. However, one intangible asset that may go overlooked is your earning potential. This can be a mistake, especially if you consider that if your income...
If you are severely injured in a fall, in a car accident or if you contract a serious illness, you may not be able to go back to your job for an extended time period. Sick leave and short-term disability may not be enough to cover your expenses if you are still unable...
The Employee Retirement Income Security Act (ERISA) is the federal law that sets minimum standards for retirement plans in the private industry. One way that ERISA protects the assets in your retirement plan is by ensuring that those who have control over their assets...
When you have serious injuries after an auto accident, you also have expensive medical bills, lost wages and other associated costs. Depending on the circumstances of the accident, your first step to financial recovery likely involves a claim with your auto insurance...
There are many different types of insurance for our readers in Texas to think about as part of their overall financial status – health insurance, life insurance, home and auto insurance and many more. However, one type of insurance that is a bit newer and perhaps not...
Uninsured or underinsured motorist claims and coverage are important for drivers who have been hit by an uninsured or underinsured motorist to understand. It is essential to be familiar with this important protection and how an uninsured or underinsured motorist claim...
Like many other states, Texas has laws on the books which prevent insurance companies from engaging in certain heavy-handed and unfair tactics in the marketplace. This law seeks to hold insurance companies accountable since they play an important role in this state’s,...
Employees who participate in retirement plans work hard for years, depending on the knowledge that their benefits will be available for them when they are ready to retire. Unfortunately, sometimes their employers try to get away without giving these employees the full...
Owning a car means you are responsible for many costs, including insurance premiums, repairs and the payment on the loan. The Insurance Information Institute states that the cost of owning a 2019 vehicle in 2019 was $9,282. When you get into a car accident, filing a...
Nothing is more stressful after you suffer from a major health problem than receiving notice that your health insurance will not cover the treatment you received. When you are trying to recover from a significant illness and injury, a denied claim can be disastrous....
In many ways, insurance is a safety net for Texans when they hit the road in their vehicles. If there is an accident, it is comforting to know that an insurance policy is likely to compensate them for property damage, injuries and even death if they are unfortunate...
Homeowners insurance is, for many Americans, an automatic. At least nine out of every 10 homeowners in the U.S. say they are covered by such a policy, according to the Insurance Information Institute. But having homeowners insurance and fully understanding what is...
Frustration, anger and heartache often arise among people who suffer from cognitive impairment. They have difficulty thinking, understanding instructions, remembering details, learning new things and making decisions. Not only can cognitive impairment affect their...
No one wants to consider the possibility of becoming severely ill or seriously injured, resulting in the ability to work; however, it is a possibility for any working adult in Texas and elsewhere. Thus, when one is met with this troubling fate, it is imperative to...
A car accident can be a traumatic event in a Texas resident’s life, and the challenges of the experience can be compounded if the responsible party leaves the scene of the collision. When a driver is involved in a car accident and leaves without communicating with the...
The Employment Retirement Income Security Act (ERISA) protects the rights all Texas workers who are covered by a pension plan or a health insurance plan issued by their employer. ERISA mandates the obligations of the employer and the insurer who has issued the plan at...
Many of us are told to get insurance to protect ourselves and our families financially after a catastrophic life event. However, merely having insurance does not guarantee that your loss will be covered by your policy. In fact, insurers may even deny valid claims to...
Austin is the heart of the Lone Star State. It is the hub of state government, Texas’s flagship university, an entertainment epicenter, and quickly becoming a mini-Silicon Valley. With all of this prosperity and activity though, comes vehicles. Thousands of vehicles...
Sudden and unexpected tragedies are an unfortunate reality of life. If you’ve had the foresight to secure long-term disability insurance, then you’re ahead of most people. Yet, far too often insurance companies either delay short- and long-term disability payments or...
Many of our readers in Texas may not be familiar with the Employee Retirement Income Security Act of 1974, which is commonly referred to as “ERISA.” This law was enacted to help employees who have insurance coverage options, as well as other important benefits,...
While no one expects to get into a car accident, Texans who find themselves in just such a quandary may feel relieved that they have the necessary auto insurance coverage, and, they assume, so does the other driver. However, this isn’t always the case. Sometimes a...
A job is a necessity for most Texas residents, but not everyone wants to work until the end of their life. As such, many individuals save, invest, and utilize work-provided retirement accounts to plan for their non-working futures. When a private employer provides a...
Texans buy insurance for many different purposes: to protect their home and property from unanticipated loss, to make sure they have health care when they need it and to protect their family in case of the untimely death of the breadwinner. A less common type of...
Like most Texans, you work hard for the possessions you have. To protect your home, car, business or other assets, you have an insurance policy. In exchange for your paying monthly premiums, your insurance provider agrees to cover certain damage. Unfortunately,...
The main purpose of uninsured and underinsured motorist coverage is to foot the bill if someone else causes your crash and they have no insurance. Ideally, this protects you from needing to pay for these costs out of pocket, as you might need to if you only had...
For Texas residents, you have short and long term disability if you need it. But which one works best for your unique situation? How can you tell which one applies to you? Today we will look at the answers to these questions. We will look into whether long or short...
If you have a rejected or delayed claim, do not immediately give up hope and do not lose your composure. Your rejection could be for any number of reasons. The insurance company could have made a mistake, or you may have made a misstep yourself while filling out the...
Are you a disabled Texan whose injuries came from work? You have options when pursuing disability insurance. Today we will focus on long term and short term disability. Each has its own purpose. Each has pros and cons. Each can suit different situations well depending...
There may come a time where you need to help your loved one apply for disability benefits. To help with a person’s application, you could be a relative, friend, employer or even a member of an advocacy group. According to the SSA, you can assist a person with his or...
Health insurance companies employ individuals whose full-time job consists of finding reasons to deny claims for medical treatment even when necessary. Whether a doctor ordered surgery, a procedure or medication, 25% of patients surveyed revealed that their health...
Reading the fine print on an insurance policy can seem tedious, and trying to understand it may be even more of a chore. We understand that these contracts tend to have "legalese" that may make it easier for an insurance company to muddy the waters and deny claims. ...
The Employee Retirement Income Security Act provides structure and oversight for private retirement plans and health plans. The federal government enacted this law in 1974. As with anything, things changed with retirement plans and within the employment field that led...
Few things are as frustrating as filing a claim with your Texas homeowner’s insurance company only to have that claim denied. Attorney Jon Michael Smith has seen firsthand some of the steps homeowner’s insurance providers take in their attempts to avoid paying client...
As a resident of Texas who was depending on an insurance claim, it can feel like a crushing blow to have your claim denied. But this does not have to be the end of the road for you. Today, we will take a look at denied insurance claims and what you can do to fight for...
Few things can stop you in your tracks faster than an automobile accident. Both to ensure that you have the financial resources to recover completely and to comply with Texas law, you have car insurance. Receiving payment after an accident, though, may not be as...
When bicyclists are involved in traffic accidents, the impact can be especially devastating for a host of reasons. Aside from the major concerns associated with an impact, such as the loss of life and major injuries, bicyclists may encounter other hardships in the...
Sometimes, those who file an insurance claim are able to gain access to the money that they need and deserve in a relatively timely manner. Unfortunately, this is not always the reality for many people who file a claim, whether their claim is rejected or significantly...
Following a car accident in Texas, it is understandable that you want your insurance money as quickly as possible. The same is true if a storm damages your home, if a dog bites you or if you lose a loved one in an unexpected accident. You, like many others, may count...
What happens when an injury or illness leaves you unable to work for an extended period? In Texas, some employers offer long-term disability as part of a benefits package, and those employees who take advantage of the coverage may find themselves in a much better...
In Texas, fault matters in an auto accident. After an accident, a person’s ability to collect depends on fault. If one car is responsible or at least 50% responsible, then the insurance company has to pay the other driver. While most accidents involve one driver...
Texas residents like you who have been disabled in an incident may be seeking Social Security disability benefits. However, there are several things you need to be aware of before pursuing this. For example, Social Security defines disabilities in a very specific way,...
You carry many insurance policies with the hope that you will never have to use them. If you have a long-term disability insurance policy, you probably never want to have to use it, but having it is a blessing when you do need it. It is there to help you out when you...
Although you may not have heard of it before, ERISA is a federal law that likely affects you if you receive employment benefits. ERISA stands for the Employee Retirement Income Security Act, which took effect in 1974. Despite the name, ERISA also applies to health...
Approximately half of all Americans receive health insurance coverage for themselves and their families through a group health plan provided by an employer. However, certain circumstances, such as a change in job or marital status, may put your health coverage at...
Auto accidents in Texas are rarely simple matters. The claims process can overwhelm you and sorting out who is responsible for what is complex. Situations that involve an uninsured motorist are even more challenging. At Jon Michael Smith, we often help clients file...
If you believe you have been subjected to fraud by someone masquerading as an insurance company, the Texas Deceptive Trade Practices Act (DPTA) is supposedly in place to protect you. However, the language on the Attorney General’s website states that you only have a...
After getting into a car crash or other accident in Austin, Texas, you may assume the at-fault party’s insurance company will cover your damages. However, insurance companies often use deny-and-delay tactics to avoid payouts. You have options if an insurance company...
When you need to file a claim for your employee insurance benefits in Texas, it may fall under the Employee Retirement Income Act of 1974, also known as ERISA. While ERISA was intended to protect employees by compelling employers to responsibly manage their benefits,...
The state of Texas offers disability insurance in the form of the Texas Income Protection Plan or TIPP. In order to qualify for coverage under TIPP, you need to be an active employee suffering from a non-occupational or occupational illness or injury. The Employees...
It is a good idea for all Texas residents to have some type of life insurance, but you should also have a good idea what you need before an insurance agent tries to sell you on a policy you do not need. It is hard to know where to start, but according to Policygenius,...
One way long term disability coverage defines disability is through the various ways your disability limits your options for returning to work. Some policies will pay out if your disability only prevents you from working at your current job. Other policies, however,...
Although you may be fully insured with the right coverage every time you hit the roads in Texas, the truth is that many drivers on the road are not. According to Allstate and a study done by the Insurance Research Council, up to one in eight drivers are uninsured....
You have worked your whole life and, as you near retirement, you are depending on the benefits you earned through your pension or employment-based plans for support. Accessing these benefits, however, is not as simple as just retiring from your job. Therefore, you...
Disability payments are essential for employees to maintain their standard of living after they are unable to work due to a workplace injury. Unfortunately, not all employer insurance companies in Texas wish to pay what is owed to the employee. When the company denies...
Typically, when a homeowner files an insurance claim it is because the home has substantial damage that needs reparation fairly quickly to prevent additional and costly issues. Unfortunately, home insurance companies rarely, if ever, consider a homeowner's needs,...
Typically, many people in Texas think they need insurance to cover medical treatments in the event of an illness of injury with the hopes that recovery will be just around the corner. Unfortunately, this is not always the case, since some people may end up with a long...
Losing your job is a qualifying event for having to drop out of your company health care plan. In fact, the term “qualifying event” is language you see all over the health care insurance map. “Special enrollment” is another term you will see...
From an auto insurance claim to business issues and property coverage, there are many different ways in which policyholders are covered. Unfortunately, unexpected challenges can arise, and these situations may pose serious challenges for those who are trying to...
In many automobile accidents that do not involve significant injury, the drivers involved exchange insurance information. However, you might be struck on a Texas road by a driver who possesses no insurance. The driver may not even stop to provide information and will...
Many health insurance delays are not actually the result of unethical administration by your insurer, so if you find your treatment is not promptly receiving coverage from your insurer, it is a good idea to make a few phone calls first before assuming that your Texas...
Whether you need to submit a claim on a homeowner's, disability, life or another type of insurance policy, the process can be complex. As a result, many people make one or more mistakes, leading to a denial or delay of the claim. Even a denial does not always mean the...
Texas state laws require every individual who owns and operates a motor vehicle to carry insurance. When you get in an accident, you expect your insurance company will take care of the damage and your medical bills. Insurance company adjusters obtain something called...
Most of the insurance companies you are likely to encounter in the Texas marketplace aim for a high standard of professional ethics. They would assess the risks of carrying your policy, charge a fair premium and pay up in the event something unfortunate occurs....
From health to auto insurance, you rely on these coverages when you need them most. Unfortunately, insurance companies frequently deny such claims for a litany of reasons. When it comes to health insurance claims, denials can result from minor transcription errors to...
When you purchase a life insurance policy in Texas, chances are, you do so expecting that it will help your loved ones regain their financial footing after your passing. Similarly, if you are the beneficiary of a particular life insurance policy, you probably expect...
There is good healthcare available in Texas, but it is unlikely you would be able to easily handle the cost on your own. Your employer's group health care plan provides a crucial safety net: If you or your family members were to get injured or fall ill, the financial...
As a resident of Texas who has a long-term disability insurance policy through your place of employment, chances are, the tenets of the Employee Retirement Income Security Act of 1974 apply to your policy. Therefore, if you file a claim and receive a denial in...
While there are many advantages to owning a home in Texas, there are also many significant issues that can arise in the wake of a catastrophic event. If your home becomes damaged or destroyed due to fire, plumbing leaks or severe weather, your insurance company will...
Being struck on a Texas road by a driver who does not possess insurance can be a true burden for the driver who was wronged, as the other motorist’s lack of coverage can make receiving compensation harder. But what does it mean if a driver is underinsured? While...
As a Texas resident with a health insurance policy, you have the right to question your insurer’s decisions if the company denies you coverage or decides to terminate your relationship. The first step in the process involves requesting what is known as an...
As a Texan resident, you may have considered the uses of long-term disability insurance before. If you are suffering from an injury or ailment, you may be wondering how to make a claim. , attorney, is here to help you through your...
Employers typically present group healthcare plans as important employee benefits during the hiring and contract negotiation processes. Unfortunately, Texas insurers are not always enthusiastic about paying up — even when the people make claims...
The upside of rejecting uninsured motorist insurance in Texas is obvious to many people: it would likely reduce monthly auto insurance bills. The disadvantages of opting out are probably greater in most cases, although they could prove somewhat more difficult to...
Protecting your family financially is an important consideration. That is why, at the legal practice of , our team does everything possible to hold Texas insurers to their promises. However, our ability to secure benefits or damages is...
At our law offices here in Austin, we are proud to be part of the team supporting in providing representation for people who are struggling with insurance companies' failures. Our goal with our clients from across...
Life insurance is an important precaution that can be of immense help to beneficiaries at a difficult time in their lives. The last thing you want to hear when you are in the position of having to make a claim is that the insurer is delaying or even flat-out denying...
If you have been diagnosed with a chronic condition that makes it difficult for you to continue working, you may rely on your long-term disability benefits to make ends meet. When you file a claim for long-term disability, the claim administrator over your case will...
If you live in Texas and experience a car accident, develop a medical condition or otherwise have cause to file a claim with your insurance company, you may be counting on the entity to provide you with what you need to move forward. Regrettably, however, insurance...
If you, like many others across Texas, have ever filed an auto insurance claim after a car accident only to receive a denial in response, you probably understand all too well just how infuriating this can be. Expecting to receive a certain amount of money after your...
If you have filed a claim with your health insurance only to have it denied, you know just how frustrating it is to face this situation. There is a myriad of reasons this might occur, but the result may leave you feeling as though you have hit a dead end. Many...
If you are a Texas resident who has ever had the unfortunate experience of having your health insurance claim denied, you may know full well just how anxiety-inducing this can be. An unexpected claim denial can leave you facing massive medical bills, leaving you in...
Anyone who has received health insurance benefits from an employer in Texas has probably benefited — indirectly, at least — from the Employee Retirement Income Security Act of 1974. Some have also taken advantage of a prominent amendment to this...
An insurance rider is like a valuable feature added on to an automobile. While all automobiles can carry you from one location to another, you would not settle for just any vehicle from the lot. Instead, you would shop for the Texas automobile that matches...
One way insurance companies may try to turn you down for an injury claim is to say that whatever injuries you have sustained are either exaggerated, misdiagnosed, or do not exist. Showing the results of medical exams from your Texas doctor that prove you...
Getting struck by a motorist who does not carry the proper insurance can add more frustration and anger on top of the damage your automobile has sustained. After all, the law requires motorists to carry insurance in the event of an accident, so it feels...
Regardless of your age, there is a chance that you could become disabled either through an accident or due to a medical condition. To help plan for your future and ensure you can still take care of your obligations in Texas should you become disabled, you have the...
When you become ill or injured, or your property sustains damage, you look to your insurance provider to cover the cost of care or repair. After all, the whole point of having an insurance policy is to prepare for the time when an accident happens and you need that...
Being laid off in Texas can cause a person to fret about providing for one's self in the future. For example, if you possess a retirement pension at your job, one of your concerns may be whether you can maintain that pension or if you can at least collect on the...
If another vehicle hits your vehicle in Texas, you have the right to assume they carry proper insurance coverage and can pay for any damages. It is normal to expect the person at fault to cover expenses of an accident, but in some cases, the person that hits you may...
If you own property in the Austin area, chances are high that you have an insurance policy on it. You purchase homeowner's insurance for peace of mind against the unexpected. As long as you pay your premiums, you expect your insurer to cover damage that occurs from...
Families depend on life insurance to survive if something were to happen to one or more breadwinners. Collecting benefits can be the only comfort in a time of mourning and uncertainty. However, some families discover the unfortunate truth: many insurance companies...
At times, Texas employees may file a claim with their insurer only to see it denied. If your insurance plan is covered by the Employee Retirement Income Security Act of 1974 (ERISA), this law provides for you to sue your insurance company in court to try and...
How a recorded statement can affect your insurance claim
Texas state laws require every individual who owns and operates a motor vehicle to carry insurance. When you get in an accident, you expect your insurance company will take care of the damage and your medical bills.
Insurance company adjusters obtain something called a recorded statement after filing a claim, and your answers affect how the insurance company proceeds. What is a recorded statement?
