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Austin Insurance Law Blog

People who need disability insurance

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 term disability that prevents them from working and deprives them of a steady income. This is where disability insurance comes in. Just about anybody might need disability insurance, though some groups of people are more likely to purchase it than others.

According to U.S. News and World Report, individuals most likely to purchase disability insurance are professionals who are still active in the workplace. They buy disability insurance so that they can replace their income if they become disabled. However, people who need disability insurance the most are often the people who cannot afford the premiums on their budget. These individuals usually have a lower income that only allows them to put away a small amount of money, so paying the premiums is not feasible.

Health care plans, special enrollment and qualifying events

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 associated with various plans. What does all this mean?

The consequences of a denied insurance claim

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 recover from significant losses. Many people are relieved to know that they were covered when something went wrong, but they may be dismayed to find out that their insurance claim has been denied. Regrettably, there are many consequences associated with denied insurance claims for people in Austin and all across the state of Texas.

If your insurance claim has been denied, you may be struggling with many different hardships. First of all, you could be overwhelmed with uncertainty and stressed out about the entire situation. You may also be facing massive financial difficulties and a denied claim may leave you financially devastated. For example, if an insurance claim is denied you may find yourself in a position where you are considering bankruptcy, cannot move forward with business plans or are no longer able to your bills. For some people, such as those who have kids that are attending college or serious health problems, a denied insurance claim can be especially hard to deal with.

Gathering information for an uninsured driver collision

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 just leave. If you cannot gain the other driver’s insurance details on the spot, there are other ways to establish who the other driver is and to try to receive compensation.

Esurance explains that, in a situation where you cannot acquire the other person’s insurance information, you should attempt to jot down all the details about the other vehicle that you can to assist in the claims process. You should try to recall the license plate number if you can, but any detail, from the color of the vehicle to the make or the model of the vehicle that struck you could be important.

Who should I contact if my medical insurance is delayed?

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 insurance company is intentionally causing trouble for you. explains who you should contact in the event you experience delays in your health coverage.

First, if you have direct questions about the amount your hospital or doctor has posted for your treatment, it is a good move to call your doctor or contact your hospital to ask about it. It is likely you will first talk to a person who controls the billing in your doctor’s office. If you feel it is necessary, you will probably want to speak to your doctor as well.

Do not take an insurance provider's ethics for granted

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. However, you should be aware that this is not always the case.

At the office of Jon Michael Smith, our team knows that any some insurers have a different way of doing business. We have seen some companies that deny claims to delay payment, others that have internal errors leading to unjust rejections and even a handful that are downright misleading in their policy documentation and sales processes. Our job is to review each potential clients' case to see which if any of these situations applies.

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?

Top insurance claim errors to avoid

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 end of the road; rather than giving up, you may be able to file an effective appeal. However, you can increase your chances of getting your claim approved sooner by avoiding some common errors.

Denied insurance claim: You need an experienced attorney

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 using a provider out of your network. 

It is possible to appeal a decision, but it can be an incredibly complicated process. That is why you always want to retain the services of an experienced insurance attorney to assist you through this. 

Common reasons for life insurance claim denials

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 that you will have a certain amount of money available to you following the loss of your loved one. Attorney Jon Michael Smith recognizes that many life insurance providers deny claims for similar reasons, and we have helped many people facing life insurance claim denials pursue solutions that meet their needs.

According to Nerdwallet, there are numerous reasons your life insurance company may deny your claim, and some are more avoidable than others. It is essential, for example, that the policyholder pay all premiums in a timely manner, because failing to do so can lead to a lapse in coverage. The policyholder must also be truthful when completing the life insurance policy application in the first place, taking care to answer questions about smoking habits, medical history and similar matters honestly. This can prove particularly important if the policyholder dies within two years of purchasing the policy.

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Jon Michael Smith Attorney

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Austin, TX 78731

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