Austin Insurance Law Blog
Texas statutes can be used to hold insurers accountable
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,...
Understanding ERISA claims
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...
What happens when you file a car insurance claim?
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...
Reasons your health insurance claim may be denied
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....
Key points about uninsured auto insurance claims in Texas
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...
Know the difference between named perils and open perils
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...
Long-term disability insurance and cognitive impairment
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...
What you should know about long-term disability insurance
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...
Uninsured motorist claims after hit-and-run accidents
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...
Making a claim for medical benefits under ERISA
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...
Filing a lawsuit against an insurer for claim denial
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...
What happens if you’re in an accident in a borrowed vehicle?
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...
Don’t let disability insurance companies push you around
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...
The right approach to ERISA claims in Texas
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,...
What happens when I file an underinsured motorist claim?
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...
ERISA Claims Based on Breach Fiduciary Duties
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...
Understanding the basics of disability insurance
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...
Insurance providers have a duty to investigate claims fairly
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,...
Is uninsured motorist coverage worth the cost?
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...
Do you need long or short term disability?
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...
Do not let rejections or delays intimidate you
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...
What is the difference between short and long term disability?
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...
Can you help someone with the disability application?
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...
Necessary medical treatments denied for one out of four Texans
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...
What you don’t know about your auto insurance could hurt you
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. ...
What are the important amendments to ERISA?
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...
What to do after a homeowner’s insurance claim denial
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...
Was your insurance claim denied in bad faith?
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...
4 common reasons for denied auto insurance claims
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 a bicyclist is hit by an uninsured driver
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...
Dealing with a delayed insurance claim
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...
How fast must an insurer pay a claim in Texas?
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...
Understanding long term disability coverage
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...
Accident claims: what to do when the other driver is uninsured
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...
How does Social Security define disability?
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,...
How does the process for filing for long-term disability work?
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...
Your employer’s responsibilities under ERISA
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...
What you need to know about COBRA coverage
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...
Benefit of uninsured motorist coverage
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...
Does the DPTA really protect you?
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...
4 ways an attorney can help with a denied insurance claim
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...
An attorney can help with complex ERISA claims
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,...
How can a preexisting condition affect a disability claim?
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...
How much life insurance do you really need?
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,...
How does a disability policy define disability?
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,...
Can you prepare for a run-in with an underinsured driver?
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....
How do you access your benefits after retiring in Texas?
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...
How to file an ERISA claim
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...
How long does an insurer have to pay your homeowners’ claim?
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,...
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...
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...
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...
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...
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...
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...
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...
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....
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...
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...
When is COBRA a good idea?
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...
Filing an appeal after a denied ERISA claim
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...
Insurance adjusters are not your friends
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...
What does it mean to be an underinsured driver?
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...
Understanding your health plan’s internal appeals process
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...
What should you know about long-term disability insurance?
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...
Your rights under ERISA
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...
Pros and cons of opting out of uninsured motorist coverage
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...
Choosing a life insurance policy
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...
Holding insurance companies accountable for their promises
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...
What is a life insurance contestability period?
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...
What to do if your long-term disability claim is denied
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...
Examples of bad faith insurance tactics
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...
How can you fight an auto insurance claim denial?
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...
3 things you should know about ERISA
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...
Tips for avoiding a heath insurance claim denial
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...
What COBRA and ERISA mean for employees
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...
The importance of disability insurance riders
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...
The facts about independent medical examinations
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...
What is uninsured motorist coverage and must I carry it?
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...
What is long-term disability insurance?
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...
Tactics insurance companies use to delay or deny claims
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...
Choosing between pension annuities or lump sums
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...
What happens when you get hit by someone with no insurance?
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...
3 reasons your homeowner’s insurance provider may deny your claim
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...
Life insurance companies may cut costs at your expense
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...
How can I increase my chances of winning a ERISA suit?
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...
3 things to do if your health insurance claim is denied
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?
