The Three “Ds” of the Insurance Industry: Delay, Deny, Defend
U.S. insurance companies rake in billions of dollars in profits every year. How do they make so much money? Unfortunately, many-even the most well known and respected-engage in dirty tricks and unethical behavior to boost their profits. Some of the most common tactics can be referred to as the three “Ds”; delay, deny and defend. Every dollar not paid out on a claim is a dollar that goes into the insurer’s bottom line!
The first “D” is delay. A claim is made and the process begins. You need to fill out a form, it was not filled out correctly, more paperwork needs to be completed, the filing was not timely, the loss is not covered, and so on. Back and forth we go on the insurance company merry-go-round! Meanwhile, the benefits that the company is supposed to pay out remain in its pocket, inflating its profits! The hope is that the more difficult the company makes it to collect and the longer the delay, the more likely it is that a person with a legitimate claim will just give up and drop it; hence the insurer wins! Delay is an especially effective tactic with certain kinds of accidents (such as Personal Injury, Slip & Fall, Workers’ Comp., and Cruise Ship), where the insurer, employer and or company knows that the illness affecting the person making the claim adds yet another obstacle to overcome before any payments will be made.
How to Fight Back!
- Although complicated and hard to understand, try to read the insurance policy. You may find that some of the things promised to you actually aren’t true!
- Don’t give an insurance carrier a reason to deny your claim(s). Carefully read the instructions, forms and provide all of the information requested before completion. Moreover, always maintain a copy for your files.
- Send all of your communications to the insurance company in writing, whether it be certified mail, fax or by e-mail. Further, make sure that you keep the confirmations for your records should a dispute arise concerning non-receipt or timeliness of the documents.
- If you do speak to an adjuster, follow up with a letter confirming the conversation.
- Remember, the company is counting on you giving up. Just hang in there and call Evan @ (866) I SUE YOU, (866) 478-3968 for possible assistance; we will fight for the benefits that you deserve!
Debit vs. Credit
When you are pulling out the plastic to make a purchase, will it be debit or credit? It makes sense to know how each card works, and their respective pluses and minuses. The bottom line is that debit cards are fine for small and routine purchases, but credit cards as a rule, are better for major purchases and online transactions because they offer more protections if something goes wrong with the product, service or merchant.
A debit card is like an electronic check. The consumer is spending money that he/she already has in the bank. As compared with credit cards, debit cards carry the potential for greater liability if the card is lost or stolen. Under federal law, liability is limited to $50 for the fast-acting consumer who notifies the bank within two days after discovering an unauthorized transaction. After that, the cardholder could lose up to $500, or even more in some cases. On its own, a bank may choose to waive liability for unauthorized transactions if the consumer has taken reasonable precautions, but of course this policy varies from bank to bank.
For transaction errors, banks as a general rule, have up to 10 days to investigate after receiving notice from the cardholder, or up to 45 days in special circumstances. Pending the outcome of the review, banks generally must credit the account for the amount of the alleged error.
As with credit cards, debit cards offer convenience and another method than carrying cash. Unlike with credit, the consumer is not taking on debt when using a debit card. Nor is there interest or usually fees, assuming that the account is not overdrawn. It may even be possible to avoid overdraft charges by linking a checking account, savings account or a line of credit. Debit can also be used to obtain cash without the charges that come with cash advances through the use of credit.
Federal Law limits losses to a maximum of $50 if a credit card is lost or stolen, and also provides protection against credit card billing errors. When there is a problem with your purchase, there is no right to withhold payment if the consumer has used a debit card, as might be an option with credit. Another drawback for debit is the practice of putting “holds” on funds. If the final amount is not yet known, a merchant may place a temporary hold on funds for more than is actually spent, which denies the consumer access to that amount until lifted.
Federal law limits a consumer’s losses to a maximum of $50 if it is lost or stolen and provides protection against billing errors. Unlike debit, the law may also withhold payment under certain circumstances until a problem with purchased merchandise or goods and services is corrected. The most commonly cited drawbacks for credit cards concern interest rate increases, penalties and fees. In addition to possible annual “membership” fees, some charge your account for paying late and for exceeding the credit limit. Of course, unless a consumer is in an interest free grace period, it accumulates to the overall debt, especially if the cardholder pays only the minimum amount due each month. As anyone can attest, having these cards also makes overspending very easy, especially with high credit-limits and enticements such as reward programs.
The best bet to lower your credit card expenses is to:
- look for cards with no or small annual fees.
- try to enroll in “free” reward programs.
- obtain credit cards with the lowest “fixed” interest rates.
- transfer balances from high interest rate cards to ones with a lower rate.
- pay off credit cards that have the highest interest rate first.
- if at all possible, pay off your charges in full every month.
- avoid advertised companies that offer “credit counseling” that require up front fees.
- if all else fails, bankruptcy may be an option; As such, we can make a referral for you in this area of law.
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Defective Insulin Pumps
It is estimated that 25 million Americans suffer from diabetes, and their ranks are growing every day. Many diabetics are able to control their condition with diet and exercise, but others must take insulin, a drug that helps diabetics regulate the level of glucose in the blood. For many years, insulin was given by injection, but then a pump was invented. It is about the size of a cell phone that introduces insulin into the body at the same rate that it would be produced in the pancreas of a healthy person.
More than 400,000 Americans use insulin pumps, which allows many diabetics to lead nearly normal lives.However, insulin pumps do not always work as designated. After 18 different models were recalled over a 5 year period, the FDA (Food and Drug Administration) appointed a panel to review the issue.
The panel issued its findings in 2008, reporting that it had discovered that insulin pumps were associated with more than 300 deaths and 12,000 serious injuries. Some of the diabetics using insulin pumps received too much insulin, while others too little. Although some of these injuries or deaths may have resulted from user error, a disturbingly high number were caused by unknown problems with the various models of insulin pumps that have since been recalled.
A number of product liability lawsuits have been filed against insulin pump makers. Some of these allege that there is a specific problem with a pump, while others complain that manufacturers did not give users enough information about how to use them safely. These claims fault the manufacturers for producing a product that can injure users in ways that they are unable to guard themselves against. If you suspect that you or someone you know or love has experienced an injury, illness or even death due to the use of an insulin pump, the first step is to consult our law firm @ (866) I SUE YOU, (866) 478-3968. This law firm along with our trusted group of attorney colleagues can help evaluate the facts and determine whether there is a valid claim. If so, a fight can go forward to try and obtain the compensation that is deserved.
Scaffold Accidents and Injuries
Construction workers have one of the most dangerous occupations, with thousands of people killed on job sites every year and many more injured. Some of the most common construction accidents involve scaffolds or other types of lifts. These accidents can be very serious and usually result either from falls due to defective scaffolding or from objects plummeting from scaffolding that injure a worker below.
Unfortunately, suits involving injured construction workers are often more difficult to handle than other kinds of injury cases. An injury or death at a construction site involves the acts of many workers employed by different companies, each of whom is pointing at someone else as the party responsible. The question of liability can turn on whether a party is the property owner, the general contractor, the subcontractor, or someone else. Because of these complexities, it is vital to have a lawyer involved in a construction injury case ASAP! If you or a loved one has been injured on a construction site, contact our office and let us go to work for you.
Smoke Alarms: Inexpensive Guardian Angels
If you could pay $20 and, in return, get a guard who would warn your family if your house ever caught fire, would you? Of course you would. Despite this, most of us do not have enough smoke detectors in our homes-detectors that will stand guard over our family’s lives 24 hours a day, 7 days per week, 365 days a year! The evidence shows that using even an inexpensive smoke detector increases your family’s chance of surviving a house fire by 50%, making it one of the best investments you can buy!
Experts recommend installing smoke detectors, the cheapest of which start at less than $20, throughout your house. At a minimum, install one detector for every floor and one outside of each bedroom. Test your smoke alarms once a month and replace the batteries once yearly! Make sure that every member of your family knows (1) what to do when the smoke alarm sounds, and (2) the fire escape route from each room. A little advance planning can help make sure that you and your family have a better chance if a fire should start in the night.
Most people think that the job of an insurance company is to pay covered claims. Nothing could be further from the truth. In fact, they regularly refuse to pay claims that should be covered. Moreover, many adjusters are rewarded that pay the fewest claims while others are disciplined for approving too many!
Claims are denied for any number of reasons: arguing interpretations of policy language, willful distorting of the facts and even out-and-out fraud. In other cases, the insurer will “audit” the initial insurance application and claim (often falsely) that it was not filled out properly or that the person did not disclose all of the facts, and they then use this as an excuse to drop coverage entirely!
Denial of claims is effective because, as with delaying payment, many people do give up and simply drop the matter. Of course, every dollar not paid out on a claim is a dollar that goes to the company’s own pocket book!
Finally, there is a third “D”, defend. If all else fails, a person with a legitimate claim may have no other choice but to force the insurer to defend itself in court. This all but ensures further delays (possibly years) while the issue(s) is/are being litigated. Unfortunately, some state and federal laws are making it even more difficult to force a responsible party (e.g. whether it be an employer, merchant, company, insurer, Social Security and cruise line) to pay. This increases the incentive for the insurer to delay, deny and defend. So what is a person to do? All too often there is only one answer. Contact us @ (866) I SUE YOU, (866) 478-3968.
Car Safety: What If Your Brakes Fail?
Although quite rare, total break failure can be quite terrifying and dangerous. As in all emergencies, remaining calm is the first and most important step. In addition, the following actions may improve the situation:
- Try pumping the brakes.
- Shift into a lower gear if you have an automatic transmission.
- Downshift into a lower gear if you have a manual transmission.
- Engage your emergency brake.
- Pull to the side of the road or into a large unoccupied area.
- Put on your hazard and headlights.
- If your wheel does not lock, turn off the engine.
- Use your cell phone and call for help!
Actual resolution of legal issues depends upon many factors, including variations of facts and state laws. This newsletter is not intended to provide legal advice on specific subjects, but rather to provide insight into legal developments and issues. The reader should always consult with our law office at (866) I-SUE-YOU before taking action on matters covered by this article.