WHEN
PURCHASING A POLICY
1.
Insist on receiving a full and complete disclosure of all key provisions in any
policy you are thinking of buying. This should include an explanation of what
is and is not covered by the policy as well as a full disclosure of any waivers
of rights required by provisions in the policy. You need to know about all important
coverage, exclusion, limitation and restriction provisions. You also need to know
about any kind of binding arbitration agreement contained in the contract and
how it works.
2. Based on the information
you provide, you are entitled to receive a careful evaluation of the amount of
coverage you need, and an explanation of the exact basis for the amounts of coverage
being provided. This is in order to assure that the coverage under the policy
is sufficient and in order to avoid underinsurance in the event of a loss.
3.
Make sure the insurance agent provides you with a comprehensive explanation of
all applicable deductibles on the coverage you are buying.
4.
You should be sure to read the insurance application yourself, before it is submitted.
If there is any significant misstatement or omission in this application you could
wind up paying premiums for years only to have the company rescind (refuse to
honor) your coverage at the time of a loss.
5. You have the right to be shown a copy of the actual policy being purchased,
before you purchase it.
6. Ask if your
policy is governed by ERISA. ERISA policies take away all of your rights under
state insurance laws and regulations. Since there are NO federal protections or
safeguards against insurance company fraud, this leaves you with no bad faith
protections at all. Ask the agent whether there is an alternative, NON ERISA policy
available for you to purchase.
7. Ask
the agent whether any fines, disciplinary actions, jury verdicts or appellate
rulings have been rendered against the company whose policy you are considering
within the previous five years. If so, find out what that was all about.
8. If the company's insurance agent misrepresents the coverage offered, the company
is responsible and must make good on the agent's promises.
WHEN
MAKING A CLAIM
Exercise your rights.
1. You have the right to receive fair,
objective assistance and advice regarding all aspects of a covered claim before
you submit the claim.
2. You have the
right to have all legitimate claims thoroughly investigated, promptly evaluated,
fairly assessed and fully paid.
3. You have the right to be advised of
all coverage provisions which may have application to a particular claim.
4. You have the right to a prompt, complete, written explanation of any claims
denial or under-payment.
5. You have
the right to receive a written copy of your state's Unfair Claims Practices Act
and of your state insurance department's regulations applicable to the handling
of claims in your state.
6. You have
the right to have any ambiguity in the language of your policy
interpreted
in your favor and against your insurance company.
7. You have the right to be informed in writing of any and all disciplinary actions,
fines, jury verdicts, appellate rulings or other actions taken within the fast
five years against your company. Find out what the company has been accused of
in the past. This may tell you something about what to watch out for in your claim
situation.
* Don't let any agent or claims adjuster
duck any of these issues by telling you that he or she is not a lawyer and can't
comment on these things. The company wrote the policy. They have handled hundreds
of thousands of matters regarding all of these issues. They know about all of
the things discussed here. You have every right to know them as well.
One
last thing. Take notes. Whenever you have any conversation with an agent, adjuster
or other company representative, write down what the person says and save your
notes in your insurance file. They may well prove extremely valuable to you in
the future.
