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Austin Insurance Law Blog

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 for benefits that are well within the scope of the policies.

For those who come up against resistance while filing a claim, it is often important to realize that an important federal law protects the rights of employees. This often helps relieve some of the stress that comes from going against large, powerful institutions, such as insurance providers and employers.

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 enumerate and explain.

Many people see underinsured or uninsured driver coverage as supplemental to standard insurance policies: this is true, legally speaking. However, despite the fact that these insurance products are not mandatory, injured drivers routinely benefit from their coverage. 

Choosing a life insurance policy

Protecting your family financially is an important consideration. That is why, at the legal practice of Jon Michael Smith, our team does everything possible to hold Texas insurers to their promises. However, our ability to secure benefits or damages is limited by the scope of internal insurance company negotiations and courtroom proceedings. Choosing the right insurance policy could go a long way towards securing your family's future.

You might also want to look beyond insurance. Our life insurance dispute clients often suffer from an immediate lack of funds due to delayed or denied claims. While it may seem redundant, you might avoid this issue by keeping an emergency savings account to tide family members over until they resolve their insurance issue.

Holding insurance companies accountable for their promises

At our law offices here in Austin, we are proud to be part of the team supporting Jon Michael Smith in providing representation for people who are struggling with insurance companies' failures. Our goal with our clients from across central Texas and beyond is to guide them efficiently and compassionately through complex, frustrating appeals and trial processes.

Big insurance companies do not scare us away. When we take a case — regardless of the size of our opponents — we represent the interests of our clients patiently and tenaciously, always with an eye towards obtaining the compensation necessary to deal with disabilities and maintain reasonable standards of living. 

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 your claim.

One common situation when insurers conduct a close investigation into a policy's documentation is when the death occurs within Texas' contestability period. The law allows insurers to investigate and contest claims that beneficiaries submit within two years after the policy takes effect.

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 determine whether there is sufficient evidence indicating that you suffer from a disability and truly deserve benefits. However, there are incidents where long-term disability claims have been denied, even when medical documents show that there is an actual case of disability. What do you do when your claim has been denied?

The Employee Retirement Income Security Act gives you the right to appeal your denied claim. First, you may want to request your file from the insurance company. This shows all of the evidence, such as doctors’ files, memos, charts and reviews, the administrator used to make his or her decision to deny the case. Now you can check for any incomplete information or miscommunication that may have occurred in your files. You can also get detailed medical letters from your physicians indicating your chronic condition and how it acts as a disability in your life. You can also include notes from your employer and people in your life who witness your struggle on a daily basis.

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 companies sometimes prioritize profits over those they insure, which can leave you wondering how you will begin to rebuild without their assistance. Attorney Jon Michael Smith built a career upon going to bat against unethical insurance companies, and he has helped many victims of bad faith insurance seek appropriate recourse.

Per FindLaw, “bad faith insurance” essentially refers to unethical, unfair or dishonest practices on the part of an insurance company. Bad faith insurance tactics are not industry-specific, meaning they can arise from auto insurers, health insurers, homeowner’s insurers and so on. Bad faith insurance tactics can take on many different forms, though some are more common than others.

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 accident and then hearing that you will instead receive nothing at all can leave you scrambling to figure out how to make up the difference. You might be remiss, however, to simply accept your insurer’s claim denial without a fight, and there are certain steps you may be able to take to help fight your denial.

Per The Street, you may be especially wise to fight back against your insurer if the accident in question was not your fault, and you receive a claim denial despite fully understanding the terms of your policy. After all, insurance companies are businesses, and at the end of the day, they are out to make a profit – but you do want to make sure that they do not make that profit at your expense. So, what can you do to help argue your side?

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 people do not realize that the Employee Retirement Income Security Act covers certain health care-related claims. 

ERISA, also known as the Employee Retirement Income Security Act, is a law passed in the 1970s that dictates administration of employee pensions and insurance. It exists to protect employees who receive such benefits through private companies facilitated by employers. If this applies to you, you should know the following three facts about ERISA.

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 the hole without knowing how you are going to pull yourself out. Attorney Jon Michael Smith understands how upsetting it can be to have your insurance company deny your claim, and he has helped many clients facing similar circumstances pursue appropriate recourse.

Per Nerdwallet, insurance companies issue many health insurance claim denials for similar reasons, so recognizing factors that commonly lead to claim denials can help you avoid one in the first place. You may hear, for example, that you received a claim denial because you visited an out-of-network medical provider. Typically, insurance companies work with certain providers who have an existing understanding and agreement about billing practices, so check with any medical provider before signing on to make sure it falls within “your network.”

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Jon Michael Smith Attorney

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Austin, TX 78731

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