When you've been injured or suffered a loss, the last thing you expect is for your insurance company to turn its back on you. But that's what happens when they deny your claim. You've paid your premiums and played by the rules, and now you're left feeling frustrated,...
If you have an employee benefit plan, it should follow the minimum standards set by the Employee Retirement Income Security Act of 1974 (ERISA). This federal law aims to protect the interests of employees and their beneficiaries by setting standards for retirement and...
Imagine being involved in a severe car accident, only to learn that the at-fault driver does not have insurance. You are left with mounting medical bills, lost wages and a sense of uncertainty about how you will recover from your injuries. This scenario is all too...
You’ve diligently paid your insurance premiums, so when the time comes to rely on your policy, you expect the insurance company to be there for you. Yet, insurance companies are in the business of making money, and it’s hard for them to do that when they regularly...
If the onset of a medical condition has rendered you unable to work, then you may need to rely upon your long-term disability insurance coverage, which is typically provided by your employer. However, regardless of how clean cut your case may seem, these long-term...
In our state, driving without proper insurance coverage is illegal and carries severe consequences. This post explores how Texas deals with uninsured and underinsured drivers, the penalties they face and the options available to car accident victims. Uninsured and...
Experiencing a car accident and finding out the at-fault driver has no insurance can be extremely frustrating. This is especially true because Texas law mandates that all drivers maintain a minimum level of Personal Injury Protection and auto insurance coverage....
A prolonged illness or injury can prevent you from earning a living for an extended amount of time. On top of your health issues, this can be financially devastating for you and your whole family. One way to protect yourself in advance is to apply for long-term...
We’ve discussed insurance bad faith on this blog in the past. It’s a real problem, and one that can have tremendous financial implications for those affected by it. While there are legal steps you can take to try to hold an insurance company accountable for its bad...
Recently in this blog, we discussed how climate change and natural disasters are contributing to a crisis in homeowners insurance. In this blog post, we will address how many of the same issues are affecting farmers. As reported recently in the Texas Tribune,...
As Texans know, insurance coverage has never been more important. We use it for our homes, cars, life and health. But, many may not know that you can even use it for your business too. Business interruption coverage stands can be a crucial safety net for businesses....
In Texas, one issue that can be costly in every conceivable way is if a person suffers an illness or injury that leaves them unable to earn a living for an extended period. In these circumstances, long-term disability insurance coverage can be a lifesaver. However,...
Many insurance policies are sold on the premise that purchasing the policy will remove all stress from the insured’s future. Unfortunately, insurance sellers are not as forthcoming about the possibility of the insurer denying a claim as they are about the supposed...
Making a claim to your homeowner’s insurance is nerve-wracking. You worry about being denied, and you worry about the effect on your insurance costs. However, you may not think about how supplemental costs are handled. Once your homeowner’s insurance claim in Texas...
Social Security Disability Insurance (SSDI) provides important financial assistance to persons who have been disabled by an injury or illness. Unfortunately, the vast majority of SSDI benefit applications are denied at the first level of administrative review. Persons...
We've all been hearing a lot about artificial intelligence over the past few years. Much of this discussion concerns AI-generated imagery and its implications for art, entertainment and news. We sometimes fail to notice how the technology is already at work in some...
Most businesses that purchase liability insurance policies expect the insurer to provide a defense if the policy holder is sued for a negligence act. In the mind of most insureds, the duty to defend is the same as the duty to indemnify. Unfortunately, the two...
Austin residents may hardly think about their health insurance as they go about their daily lives. They may glance over their Explanation of Benefits and just pay what the provider says the provider is owed. But in a major health crisis or after a serious injury,...
According to the Insurance Information Institute, Texas has relatively few uninsured motorists on its roads when compared to other states. However, there are still enough people driving without insurance in this state to present a serious economic problem for both...
Our readers in Texas understand the basic concept of an insurance policy: the policyholder pays regular premiums and the insurance company pays any valid claims when necessary. Most people in Texas have home insurance, car insurance, health insurance, life insurance...
In recent years, parts of the United States have experienced many staggeringly expensive natural disasters, including wildfires, floods, storms and more. In 2023, Texas experienced 16 disasters in which the cost was $1 billion or more. This was highest number of...
For Austin, Texas, homeowners dealing with property damage, the expectation of a swift and equitable settlement from their insurance company is common. However, many find delays, denials or inadequate offers. The first question is often how long they have to respond...
ERISA -- the Employee Retirement Income Security Act of 1974 -- is designed to protect workers who have employer-sponsored retirement benefits and health plans. One way it does this is by imposing minimum standards on these plans. ERISA also protects the rights of the...
Given the recent weather-related insurance disputes, people in Texas are increasingly concerned about the limited options they have when they are seeking property insurance. Obstacles aside, it is imperative to have some form of insurance in case of a storm, fire,...
Many people purchase life insurance to ensure their loved ones are financially protected when they pass away. A claim for payment under the policy may be denied, however. The beneficiaries of the policy may have an opportunity to appeal. Life insurance overview A life...
Most Texans are familiar with the process of purchasing insurance. Once the need for insurance is identified, the person who seeks the insurance contacts an agent who sells the kind of policy (homeowners, automobile, business interruption and the like) and asks for...
As our readers know, we tend to do things differently in the Lone Star State. And, this may lead one to wonder whether ERISA claims are treated differently in Texas too. What is ERISA? ERISA is the federal law regulates employee benefit plans. Benefit plans include...
Long-term disability in Texas pays you a portion of your income if you become disabled while you are still working. Unlike short-term disability, which pays you benefits until you can resume working, long-term disability may continue for many years. There are many...
On its website the National Centers for Environmental Information's has a map noting every billion-dollar weather-related disaster in the United States so far in 2023. Calling a disaster a billion-dollar event means its damages are estimated to cost $1 billion or...
Like every other state, Texas has a regulator in charge of making sure insurance carriers and others in the insurance business follow the laws and regulations in this state. In this role, they also have some authority to advocate for policyholders and to enforce some...
Business owners may encounter situations that are beyond their control which cause them to suffer serious financial losses. Business interruption insurance is intended to help a business cover loss from an event that interferes with their normal operations. Business...
Any Texas resident who has had to interact with an insurance company before on a claim probably knows that the potential difficulty in that situation cannot be overstated. Although we all pay for insurance policies for a variety of reasons – car insurance, life...
If an insurance policyholder makes a claim, they may think that all they need to do is send the information to the insurance company and they’ll be done. In some situations, however, the insurance company may have the policyholder undergo an examination under oath...
Every year, about 5% of American workers face a temporary disability of six months or less. Their reasons can include pregnancy, injury, physical illness or mental illness, but the common factor is that their condition makes it impossible for them to earn a living the...
Texas families and businesses frequently purchase liability insurance. In many cases, they must do so. Everyone who drives on Texas’s roads has to have automobile liability insurance. Personal liability insurance or commercial liability insurance may be required by...
Texas requires all drivers to carry proof that they can cover the costs of any accident they might cause while behind the wheel. This means all drivers are required to carry auto insurance. In theory, this means if you are injured in a motor vehicle accident caused by...
The Employee Retirement Income Security Act of 1975 (“ERISA”) is a federal statute that was passed to ensure the fair treatment of employees who are covered by an employer-funded health and disability insurance plan. The federal law does not directly provide any...
Long-term disability benefits usually start after a waiting period of several months and can last for years, depending on the policy and the condition of the claimant. However, not all long-term disability claims are approved by the insurance company. Sometimes, a...
Many people work years to afford to purchase a home so if it is destroyed or damaged in a fire, it can be devastating. The homeowner may assume that their homeowner’s insurance policy will pay for the repairs, but unfortunately, those claims are sometimes denied. Fire...
Dealing with insurance can be incredibly frustrating. You may have paid your insurance premiums for years only to find that when you need to pay for a medical procedure or prescription, your insurance denies your claim. What can you do in this situation? You're just...
One in four workers will suffer a disability while they are still employed. Accordingly, long-term disability insurance claims are important because this insurance pay a portion of income for workers who are unable to work because of injury or illness. Unlike...
You might own a home in Austin, Texas, but this does not mean you are safe from hurricanes that batter the Texas gulf coast. While your home might not bear the brunt of the storm, hurricanes can move inland causing a significant amount of rain to fall and damaging...
After the chaos and tumult of a motor vehicle accident, you might feel duly overwhelmed with all that there’s to do, to recoup and regroup, and it’s a lot. At the same time, it’s imperative to be cognizant of what NOT to do. Otherwise, you might significantly...
Texas residents who suffer from depression know that it is more than just a bad mood. Depression is a major medical condition that severely disrupts your daily life. You are likely familiar with some of the most common symptoms of clinical depression, which is caused...
If you live here, you probably know that this state requires all drivers to have a minimum amount of car insurance to cover the damage and injuries they cause to others in a car accident. However, not everyone follows Texas law, and some drivers may have insurance...
A delayed insurance claim can leave you in a financial bind. After all, you’re probably relying on your insurance to help you cover whatever damages you’ve suffered, whether that be medical expenses due to an injury, damage to your home or financial loss due to an...
Texas residents often purchase life insurance to provide financial security for their loved ones after their death. They may intend for it to be used to replace their salary, for a child’s education or for future savings. Unfortunately, when it comes time for a loved...
On March 23, 2023, the House of Representatives failed to achieve the two-thirds majority required to override a veto by President Biden of a bill allowing retirement fund managers to consider specific factors in investments. A Labor Department ruling in 2020 required...
Austin residents rely on their jobs to provide for themselves and their families. When people suffer injuries or illnesses and cannot work, it can create a very difficult position while they recover. Workers’ compensation benefits can help in cases involving...
Many people in Austin receive their health insurance through their employers’ health plan options. Many of these health insurance plans are governed by the Employee Retirement Income Security Act (ERISA). Like any health insurance plan, there are different coverage...
When health insurance works as it should, you don't have to spend much time thinking about it. You show your insurance card, see your doctor, pay any necessary copay, and go on your way. But when health insurance doesn't work as it should, it can be a nightmare. One...
You depend on insurance to be there when you need it most. You may require expensive medical care, incur unexpected home repair costs following a storm or require disability coverage after an injury. Unfortunately, insurance fraud is a growing issue in Texas that...
If you are engaged in a dispute with an insurance company, you know how frustrating the situation can be. Insurance companies are experienced and highly skilled in finding ways to deny claims or to pay out less than their policyholders deserve. When you are in that...
Even the most careful drivers may end up involved in an accident at some point in their lives. That is why drivers in the state of Texas must carry insurance, including at least $2,500 of personal injury protection coverage, to cover accident-related injuries and...
The Employee Retirement Income Security Act (“ERISA”) allows Texas workers to receive long-term disability benefits. After you file your ERISA claim for your disability benefits, you are likely to wonder just how long you will have to wait for a decision. The law...
Long-term disability insurance is a valuable benefit that provides crucial financial support to those unable to work for long periods of time. While the specifics of each plan vary, most plans pay 50 to 60% of your salary if you become disabled for longer than 90 to...
Has the power grid in Texas really been fixed? Will we experience grid failures like the one in the fatal deep freeze of 2021 that left Texans without power and in the cold for days? This is a debatable question. When extreme weather causes frozen pipes or power...
If you have submitted a medical insurance claim and it was denied, you will want to appeal the denial. The process of the insurance company is that they will review your coverage for medication, service or treatment, either prior to or after you file your claim. If...
It is no secret that health care costs in Texas are high and increasing each year. Without health insurance coverage, a single illness or injury can lead to financial ruin. Families pay insurance premiums each month expecting coverage when they become sick or injured....
The Social Security Administration (SSA) readily admits that most first-time applications for Social Security Disability Insurance benefits (SSDI) are denied. However, the regulations promulgated by the SSA specify several different levels of appeals that are...
Booking a trip has become more complicated and riskier over the last two years. Having insurance covering your travel can be a reasonable precaution against the unexpected, but insurance does not guarantee a refund and may be accompanied by lots of paperwork and...
You may not know how common hit-and-run car crashes have become in the United States. However, according to the Texas Department of Insurance, a hit-and-run car accident occurs every 43 seconds in the United States. That is a shocking statistic. Required car insurance...
A denied health insurance claim can feel like a punch to the gut. Expenses that you hoped would be covered are now dumped on you with the expectation that you’ll pay quickly and, if you’re like most Americans, you don’t have thousands of extra dollars sitting around...
In Texas, younger drivers are an understandable concern to others on the road. Because they are so new to driving and lack experience with sharing the road, behaving safely, navigating poor weather and tend to be reckless, auto collisions are common. When they are in...
Many residents of Austin are eligible to receive long-term insurance benefits under the Texas Income Protection Plan (TIPP). Generally, these benefits will cover up to 60% of a person’s salary or wages. Many people who receive long term TIPP benefits are also eligible...
Many employees treat health insurance plan paperwork as they do heat and air conditioning: They disregard them until an emergency arises. A federal law known as the Employee Retirement Income Security Act (ERISA) regulates employer-provided health insurance. Though...
People have various types of property, which have various values. Property that is not very expensive may not be very important for people, but most people take precautions to protect their valuable property. To help protect the property, it is common for people to...
Under the Employee Retirement Income Security Act (ERISA), employers are required to ensure that employees receive the long-term disability (LTD) benefits they are entitled to receive. However, ERISA claim denials are more common than people realize. As you begin your...
Remain open—this is perhaps the most important thing when a business suffers from damage. But sometimes, you can’t and, while your business is shut down, you’re losing money. Business interruption coverage exists for these situations and understanding the different...
As a blog, we normally focus on private long-term disability insurance. However, one form of long-term disability insurance is also federal Social Security Disability Insurance, which we have discussed in a prior post, where we focused on the injuries that qualify for...
Many Texas residents depend on long-term disability benefits to support themselves and their families when they can no longer work. Unfortunately, the process for applying for these benefits is often complicated and even the strongest applications can be denied....
Being hit by a negligent driver is bad enough but being hit by a driver who does not have insurance can be worse. According to a 2021 report from the Insurance Research Council, one in eight drivers does not carry insurance. Uninsured and underinsured motorist...
It is no exaggeration to say that driving on a public road has become increasingly hazardous for Texans in recent years. Not only must drivers navigate crowded streets to run daily errands, commute to work, or travel for vacation or to visit family, but they must do...
Texas business owners know that having a good commercial insurance policy is extremely important, and one of the best ways to protect their business. When an unexpected event occurs that causes your business to suffer damage or losses, your commercial insurance policy...
Texans depend on insurance policies to help them out should they be faced with certain terrible situations. One of these types of policies is disability insurance. There are two types of disability insurance policies. One is short-term disability insurance and the...
For many Texas workers, injuries and illnesses can be overwhelming financially and emotionally. Being protected from this potential challenge is important. So too is it important that they have a certain level of peace of mind that comes from being insured against...
Dealing with an insurance company can be a nightmare. You oftentimes have to navigate complex and confusing policy terms, and your insurance or someone else’s insurance who is going to cover your losses may be challenging to work with. As a result, you can see...
Your health insurance company is supposed to take care of you when you get injured or sick, right? While that’s certainly the hope, the sad reality is that many times insurance companies deny or delay paying claims. After all, they’re in the business of making money,...
A car accident can occur in the blink of an eye, leaving you injured, your car damages, and your emotions frayed. After the dust settles, you might breathe a sigh of relief knowing that you have uninsured or underinsured motorist coverage. But the sad reality is that...
Being insured is important for residents in Texas and elsewhere. With a traditional insurance company, a claim is filed based on the terms of the insurance contract. Thus, if an insurer refuses to pay a claim for a benefit, it is possible for them to file a suit in...
With the status of the economy in flux and many Texans struggling to make ends meet, a growing number have turned to work in which they are using their vehicles or an employer’s vehicle to make deliveries. This is an honest day’s work and can be useful as a primary...
Texas residents often purchase long-term disability insurance for the comfort of knowing they and their family will be taken care of financially in the case of an unexpected injury or illness. Everyone hopes they will not ever need to use this type of insurance, but...
Through illness or injury, many people will find themselves at a point in life where they are disabled and are no longer able to work to earn an income. For those who were cautious and made plans in the event that this unfortunate situation would arise, long-term...
The Employment Retirement Income Security Act provides oversight and structure for private health plans, retirement plans and pensions. ERISA is not a plan itself but a set of rules that set minimum standards for the operation of these plans to protect workers from...
Having insurance is a fundamental aspect of daily life in Texas. That includes health insurance, automobile insurance, home insurance and more. For those who do not have insurance or try to file a claim only to see it denied, it is imperative to be aware of their...
Losing loved ones can be very difficult for people. They lose the love, affection and support the loved one provided, which can be very difficult to replace. They can lose significant financial resources as well. The lost loved one may have provided a significant...
Life insurance is intended to provide financial support to a person’s loved ones when he or she passes away. It can be very difficult for them if the life insurance company denies their claim for benefits. Denial reasons There are some common reasons a claim may be...
Most insurance companies have language in their policies which require a person who makes a claim to cooperate with the insurance company. In the language of the insurance business, these requirements are referred to as a duty of cooperation. A policyholder who...
As a homeowner you probably feel a sense of relief knowing that you have homeowners insurance. These policies should protect you from storm damage and other kinds of losses that are covered under your policy. However, when the time comes for you to file a claim, you...
Most Austin area drivers will be in at least one car accident during their driving career. Although these accidents are not planned, they can cause serious injuries for car accident victims. Usually, the insurance company of the at-fault driver will take care of...
Being injured in a car accident is bad enough but being injured by a negligent driver who is uninsured or underinsured can be even worse. It is important that car accident victims who are left with damages know about the options that may be able to help them when they...
In Texas and across the United States, people constantly see the advertisements for potentially reduced insurance by allowing themselves to be tracked so their insurance company can see that they drive safely. Known as “telematics,” these provide a variety of...
The number of people killed on the roads in and around Austin is on track to be higher this year than it was in 2020. Recent traffic accidents pushed the city’s number of fatalities to 91. Even with over two months to go, this is already a higher number than the...
ERISA can provide many important protections for workers with concerns about their insurance and insurance claims that are being unreasonably delayed or denied. ERISA stands for the Employee Retirement Income Security Act and is important for insurance claimants to be...
Successfully navigating an insurance claim can be quite the endeavor. Even when it seems clear to you that your claim should be paid, an insurance company might do everything in its power to find a way out of payment, or at least reduce the amount of payment that...
Most Americans have insurance policies of some kind, whether it is car insurance, homeowners’ insurance, health or life insurance, for example. On most days, we all hardly think about these insurance policies and what they are intended to protect. However, when...
Liability insurance policies require the insurance companies which issued them to fulfill two basic responsibilities. First, the liability insurance company is supposed to pay valid claims. A valid claim might arise when a customer slips and falls on a business’s...
So, you or a loved one has suffered an injury or illness that has led to long-term disability. Now you’re simply trying to find the resources needed to further the inflicted individual’s recovery while retaining some semblance of financial stability. You’d hoped that...
When driving in Texas, having auto insurance is a fundamental necessity. This is the law and it is for the safety of the driver, passengers and others on the road. When paying the insurance company premiums, there is an understandable expectation that if there is an...
Regardless of the reason, filing an insurance claim is never easy. This is because insurance companies make their money by not paying out claims. However, if one is dealing with an insurance company that is delaying or inappropriately denying a claim, they may be...
As readers of this blog are aware, we are no stranger to uninsured/underinsured auto insurance claims. Indeed, if readers browse through our articles, they will see several posts on just this topic. However, today’s post will be a deeper dive into...
You may have heard the term ERISA without knowing what it really does. The Employment Retirement Income Security Act provides oversight for health and disability plans provided to employees by their employers. And it has some very specific requirements for how those...
Getting into a car accident can be a traumatic event for a Texas resident. When they or their passengers suffer injuries and losses, a motor vehicle accident can become both a financial hardship and a personal tragedy. The problems associated with a motor vehicle...
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?
