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Insurance companies rule the world. If you go to
any big city, most of the big buildings are owned by insurance
companies and banks. There is a reason for that. Insurance
companies know how to make money.
They take as much as they can from premium
payments and pay out as little as they have to when
individuals are harmed. In other words, you're in good hands
when you are paying your money but not when you need
compensation from the insurance company.
Insurance companies harm their insureds in three
ways. The most prevalent harm occurs when an individual
has an accident causing physical injury to a third party. All
insurance policies have liability limitations- the maximum
amount the insurance company will pay for harm caused by the
insured. Often times the third party is willing to accept
compensation within those limitations for his or her injuries,
even though the value of the injuries is substantially greater
than the limitations. The insurance company chooses to not
settle for that figure because they believe they will not have
to pay more than their limitations of liability no matter how
large a verdict, and they gamble on a 5 to 10% chance that a
jury will award no damages.
This works will for the insurance companies but
leaves many individual insureds facing financial ruin when
verdicts in excess of policy limitations result. For example,
in a recent case, one individual caused an accident which
resulted in medical bills to the injured party in the amount
of $21,000. The insurance policy had a loss limitation of
$15,000. The attorney representing the injured party offered
to settle for $15,000. The insurance company refused to
settle, even though there was almost certain liability. Instead
the insurance company chose to gamble and went to trial. They
believed the insured would have to pay the amount of any
verdict in excess of $15,000, and they hoped the jury might
award nothing. The insurance company's logic was, "If the
most we'll have to pay is $15,000, we may as well take a
chance; we might have to pay nothing." The jury returned
a verdict of $50,000. The individual was facing $35,000 in
personal loss, even though the insurance company could have
protected him from such loss by settling for $15,000.
That individual has the right to sue his
insurance company for the $35,000 he lost, plus the damages to
his reputation, credit rating and the stress caused by such
bad faith refusal to settle. Insurance companies additionally
often refuse to settle building and property losses which
occur as a result of fire. They allege "arson," try
to damage the reputation of the insured in an attempt to avoid
their legal obligations to pay for such loss. Individuals who
face such bad faith refusals to pay of property damage have
legal rights of recovery.
Many HMO's and insurance companies refuse to pay
the cost of necessary and effective medical treatment for
health conditions insured under the terms of the insurance
policy, especially when such treatment is expensive. Some
insurance companies have a policy of categorically denying
payments for certain treatments even when medically
appropriate. Because insurance companies will not pay for
appropriate treatment the insured does not receive appropriate
treatment and deteriorates or dies. The patient, his estate, and possibly his relatives have a cause of action for such bad faith refusal to authorized medically necessary treatments.
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