Insurance Legal Questions

Based upon the facts presented, the insurance company and the prosecutors office are probably seeing if you committed a criminal fraud by what you allegedly  stated in your insurance application and/or car accident.  Please retain an attorney before you go for the EUO to protect your rights; self incrimination issues. ... Read More

This answer does not create an attorney/client relationship.  I am a S.C. lawyer and board certified internist physician.  If you wish to protect the public and believe she is unsafe to others, the better way to do this was to not place her on the road in the first place.  I agree this is a difficult problem, but you could have spoken to your mothers physician.  This physician could have explained to your mother that she cannot drive.  You do not state whether or not you have a durable power of attorney making you your mothers conservator.  If so, and it can be shown that you deliberately placed your mother on the road, knowing that she was an unsafe driver, you could be held responsible and liable.  Again, I understand and sympathize with your predicament; but it could have been better handled by her physician. Regards, I am Michael G. Sribnick, M.D., J.D. Attorney at Law Owner of Michael G. Sribnick, M.D., J.D., LLC www.michaelsribnicklaw.com... Read More

I am not sure what the specific laws are in your state, but in Mississippi (where I am) you would not get the money until you are 21.   You need to check your local laws and see what they say, along with whatever the paperwork regarding the settlement you received when you were younger says.   Regardless, however, you can petition the Court to receive some of the money before it is all due to you.  Usually a Judge will allow disbursement of some money for some important things, like to pay for college or school books, etc.   To be sure, you should contact the attorney who is managing your trust.   Best of luck. NOTE:  This response is general in nature and should not be considered legal advice.  No attorney-client relationship exists or is formed by this response.  ... Read More

Unfortunately, your "understanding" is of no consequence in the face of a written agreement. The REAL issue is what does your insurance contract say. If it says what you understood, you would havea civil contract suit against the insurer to enforce the contract, as they are equally bound by its terms.... Read More

It is doubtful that you would receive any compensation regarding this matter.   Even if a claim was filed with the Homeowner's insurance company, it would likely be denied because a homeowner only has a duty to warn you of hidden defects and harms.  A scale in the bathroom would likely not be regarded as such.  Litigation would also not likely be successful. Litigation is very expensive and would not be warranted for damages associated with a broken toe.   NOTE:  This response is general in nature and should not be considered legal advice.  No attorney-client relationship exists or is formed as a result of this response. ... Read More

I am sorry to hear about the loss of your rental home.  If you have not already done so, you need to notify your insurance company immediately of your loss.   You should consult your insurance policy. It will have information on how to report your loss.   After the loss has been reported, the insurance company should contact you.  They will likely want additional information from you to determine the cause of the fire, etc.  They also may want to take an Examination Under Oath of you and possibly of others who were living in the home.   Soon after you report the loss, they also should send someone out to appraise the damage.   You should consult your policy regarding the specifics of the replacement value.  They differ from policy to policy, however, most likely you will have a certain amount of time to request replacement value.  Sometimes its a few months or up to a year.   Essentially it means that if you replace certain items and keep the receipts and request reimbursement for them within the time period, they will pay a certain amount of said replacement items.  Finally, consult your policy to see if you have coverage for Debris Removal.  If so, make a demand for that as well regarding the clearing of your lot.   It is very important that you read your policy from front to back and understand it. If you don't have a full copy of your policy, you can request one from your insurance company and I recommend you request a certified copy.   Best of luck. NOTE: This response is general in nature and should not be considered legal advice.  No attorney-client relationship exists or is formed as a result of this response. ... Read More

I am sorry to hear about this.  While I do not have a referral for you to an attorney in your area, I wanted to point you to some information on how to file a complaint for a HIPPA violation.  For more information, please visit:   http://www.hhs.gov/ocr/privacy/hipaa/complaints/index.html#nopackage NOTE:  This response is general in nature and should not be considered legal advice.  No attorney-client relationship exists or is formed by this response. ... Read More

It is this not unusual for there to be a disagreement among appraisers as to the value of the property. If your policy has a binding arbitration provision, I suggest you demand a hearing on the value issue. Absent that your only remedy would be to file a lawsuit in Dare County seeking damages.... Read More

Your best bet would be to hire an attorney and file a declaratory action against your insurance company to ask the court to determine if there is coverage or not.  My understanding of the law is that once you complete your task at work, and are returning home, you are not considered to be on the job.  So if you had finished working for the day and were returing home, your insurance company may have improperly denied your claim.  But the law on this issue is very fact specific, and must be looked at on a case-by-case basis.  This is why it is important that you sit down with a lawyer familiar with insurance law, and discuss your particular case with him/her, so that they may properly advise you as to how you should proceed. If you do have a judgment entered against you, and you dont pay it, a lien could be placed against you and a security suspension could be levied against your drivers license, meaning your license is suspended until the security lien is paid.  Doesnt happen in every case, but there is the possibility, so it is at least worth you sitting down with an attorney and discussing your case. Best of luck.... Read More

I am sorry to hear about your accident.  You do not "need" an attorney to negotiate with the insurance company or even to file a lawsuit. However, you may decide you want an attorney, depending on how comfortable you are handling this matter and depending on how difficult the insurance company is.   To find a reputable lawyer in your area you can look on this website, you can search on www.martindalehubbel.com, you can ask friends and family in your area, and you can consult the phonebook. First of all, you will only be covered with uninsured motorist coverage if YOU have uninsured motorist coverage.   If you do not and the other person is uninsured, then there is no uninsured motorist coverage available to you.  It is important to note that uninsured motorist coverage is to protect YOU when you are involved in accidens with other motorists who have no insurance or less insurance than you.  It is, in my opinion, the most important type of auto insurance.   If you are unsure of whether you have uninsured motorist coverage, you should consult your auto policy and/or your insurance company.  Regarding your medical coverage, it is likely just limited to reimbursement for medical expenses.  You will likely need to collect your medical bills and submit them to the insurance company for reimbursement.  However, I do recommend that you find out exactly what all coverage you have (contact your insurance company) and then read, from front to back, your auto insurance policy.  It should explain exactly what is or may be covered.   Best of luck! NOTE:  This response is general in nature and should not be considered legal advice.  No attorney-client relationship exists or is formed by this response. ... Read More

I am a S.C. Attorney and a board certified internist.  My answer does not create an attorney/client relationship, nor do I solicit clients.  Your question lacks the details of exactly what occurred and, therefore, can not be adequately answered.  In S.C. you must establish that (1) the insurer or its agent made a false representation to your grandmother; (2) the insurer or its agent had a monetary interest in making the statement; (3) the insurer or its agent had a duty to communicate truthful information to your grandmother; (4) the insurer or its agent breached that duty; (5) your grandmother justifiably relied on this information; and (6) that your grandmother suffered a monetary loss as a result of relying on this information.  I suggest that you see an attorney who, like myself, does insurance litigation. Regards, I am Michael G. Sribnick, M.D., J.D. Attorney at Law Owner of Michael G. Sribnick, M.D., J.D., LLC www.michaelsribnicklaw.com... Read More

For more information regarding HIPPA Complaints, visit:    http://www.hhs.gov/ocr/privacy/hipaa/complaints/index.html NOTE:  This response is general in nature and should not be considered legal advice. No attorney-client relationship exists or is formed by this response. ... Read More

It largely depends on the terms of the insurance contract. If for example the policy clearly excludes coverage if the insured dies from the preexisting condition within two years, there is likely no coverage. I strongly suggest you request they provide you in writing their basis for denying/delaying the claim and to set out the specific policy provision(s) they are relying. If they continue to contest the claim you will need a lawyer to carefully look at the policy and see if its provisions comply with Florida law.  You can also try filing a complaint with the state of florida, particularly if they will not give you the policy language and reason for the delay/denial. My website has a link to the State of Florida website for filing a complaint and seeking relief (if you can not find it on your own). If you have additional quesitons, or can provide me the questionable language, feel free to contact contact me in reply to this post, or email me. My information is located within the lawyers.com attorney listing.... Read More

I am sorry to hear about your brother.   I wish I had a simple answer for you but I do not.  It will depend on what the actual insurance policy states.  Some policies state that if a death is caused by drugs/alcohol then they will not pay.   You will need to review the policy in its entirety. If you do not have a full copy of the policy, you should request one from the policyholder.  Request a "certified" copy and also request a copy of the Summary Plan Description.   See what the policy says about the cause of death and how that may affect whether or not a claim is paid.   Even if you think the language is clear, you may want to have a local attorney look into it for you.  Your state laws may provide some guidance as well.   I'd review the policy in full first and then reevaluate.  If you think there is any possible way to get coverage, then consult with an attorney. Keep in mind that there are likely time deadlines (per the policy and per state law) in which you can appeal negative determinations.  Best of luck! NOTE: This response is general in nature and should not be considered legal advice. No attorney-client privilege exists or is formed by this response.... Read More

The law does not require you produce records that are not in your custody and control. You are not required to go to the doctors office and get the records. You should respond to the lawyer in writing exactly as you explained above - you don't have any of the requested documents; you were never provided with medical records by the doctor's office; you do not recall every getting bills from the doctor, but you looked and either never had them or no longer have them; etc.  On the subpoena it probably says somewhere that you can mail in the records in leu of appearing in person. If that is what it says you should be fine, but for safety, after mailing and faxing the response, your should call and confirm that you do not need to appear. Get the name of the person you spoke with in the event they claim you did not call. Hope this helps, but if you have a lawyer related to the matter, you should call them for assistance with this.... Read More

First of all this answer in no way forms an attorney client relationship.  Assuming you have again been terminated from work, you should be able to use Cobra, which is a bridge insurance plan created by the Government, to keep terminated employees from loosing their insurance between jobs. Regards, Michael G. Sribnick, M.D., J.D., LLC www.michaelsribnicklaw.com... Read More

You should look into filing a potential HIPPA violation complaint.  For more information regarding such, visit:   http://www.hhs.gov/ocr/privacy/hipaa/complaints/index.html.  Best of luck! NOTE:  This response is general in nature and should not be considered legal advice.  No attorney-client relationship exists or is formed. ... Read More

I recommend that you get a certified letter from her insurance company advising that she did not have coverage on the date of the accident.  Request that it be put in writing and be a certified document.   If she did not have coverage, you can try to report her for driving without insurance, however, that will not take care of any damages you may have.  If she has no coverage, the only other thing to try is to work it out with her on your own. You can request that she pay you out of pocket for the damages you may have.  Otherwise, you likely will have no route for recovery.  This is why uninsured motorist coverage is important.  It protects YOU against other drivers who are uninsured or who may be underinsured (have less insurance than you).  Best of luck! NOTE:  This response is general in nature and should not be considered legal advice.  No attorney-client relationship exists or is formed by this response.  ... Read More