No matter if you are in Weatherford, Mineral Wells, Aledo, Azle, Willow Park, Hudson Oaks, Brock, Millsap, Cool, Peaster, Springtown, or any other place in Parker County, at many points in your life there will be times when you buy insurance and as a result there will be many chances for the insurance company to make a mistake.
The insurance industry is regulated in Texas by the Texas Department of Insurance and complaints can be filed with that department. The courts in Texas handle disputes that become lawsuits and these disputes can wind up in the Texas Supreme Court. Guidelines and laws/statutes for insurance companies to follow are found in the Texas Insurance Code and the Texas Administrative Code.
There are many ways an insurance company can mess up.
1) The agent can make mistakes when he sells the policy.
2) The underwriting department can mess up in the way they evaluate coverages.
3) The administrators will make mistakes in the way they collect premiums and handle notices to their insureds.
4) Adjusters will not be professional in the way they handle claims.
Rarely are mistakes on purpose, otherwise it would not be a mistake, it would be an intentional act. The problem with mistakes is that they can often times be costly to the insured.
When an insurance company makes a mistake an experienced Insurance Law Attorney needs to be contacted as soon as possible. Don’t start making statements and giving recorded interviews to the insurance company until you have consulted with an attorney.
Here are the different parts of the insurance transaction.
To understand the different ways disputes can arise, it is helpful to consider the sequence of events that is likely to occur. At its very simplest, the insurance transaction can be divided into the initial sale of the policy, and subsequent handling of claims. These can be broken down further to include:
(1) The sale of the policy: Initially, the consumer and insurance company or insurance company agent must communicate to establish a contractual relationship. Disputes may arise over what was asked for by the applicant, what was represented by the insurer or agent, or the timeliness of the insurer or agent in providing coverage. Issues may also arise about the truthfulness of the applicant or agent in disclosing information requested by the insurer;
(2) Underwriting: At this stage the insurance company considers the application and determines whether the applicant is an acceptable risk. Certain types of discrimination based on risk are legitimate and are inherent in the process of providing insurance. Other types of discrimination — such as distinctions based on gender, ethnicity, or disability — are unlawful;
(3) Policy administration: During the course of the insured/insurer relationship, disputes may arise even if there is no claim. For example, the insurance company may choose to cancel or not renew the policy. The insurer may demand a premium that is higher than the insured was lead to expect. Proper notices may not be sent or may be sent late; and (4) Claims: If a claim arises under the policy, the parties may fall into disagreement over the scope of coverage, the amount of payment, the insurer’s failure to pay, or the timeliness of any payment. An insurance claim may also give rise to disagreements based on the difference between the coverage promised by the insurance company or its agent at the time of sale contrasted with the coverage given at the time of the claim.
As stated earlier, when disputes or concerns arise, speak with an attorney.
Updated: