Insurance claims can occur in many arenas. For example, if you have a claim relating to your health insurance, different bodies of law will apply depending on whether your health insurance is provided by your employer, or if you have obtained an individual policy.  Under a employer-provided group plan, a body of law referred to as ERISA will likely apply. See Resources (“Employee Retirement Income Security Act of 1974”). Other claims arise under private disability policies, life insurance, key-man policies, auto and homeowners insurance policies. Moreover, your claim may be a first party claim (you are the insurance policy owner), or a third-party policy (the person responsible for the harm is the one with insurance coverage that should pay). Commercial general liability policies will be different then a homeowner’s liability policy. Moreover, reading an insurance policy can be difficult for a layman, even if the insurance company actually sends you a copy of the policy (rather than a “summary booklet”). According to a Trial News article from December 2000, “insurance policies are the most ignored documents of commerce. [Laymen] don’t read them, either before or after a loss.” Rather, clients expect lawyers to “unravel the most arcane policy terms, yet few lawyers have the training, experience, or patience to do so.” Id.

The knowledgeable insurance coverage and litigation firm of Schlesinger Conrad, pllc will first request a certified copy of the policy, and make sure it is a complete policy. Armed with the actual and complete insurance policy, Schlesinger Conrad, pllc can determine exactly what risks are covered and whether the insurance company’s denial (or delay) is wrongful. We have the training and experience to analyze the insuring agreement and all forms, conditions, exclusions and endorsements that determine your actual coverage. Schlesinger Conrad, pllc can also make sure that, if suit against the insurance company is required, it is filed within the required timeframe. Arizona and California statutes limit the time in which suit may be filed, and insurance policies often try to limit that time even further.

Typically, the totality of the policy language will control the extent to which an insurance company is required to pay your claim. However, policy terms are often vague or in conflict. In other circumstances the courts will enforce the consumer’s “reasonable expectations,” rather than the policy language.

Therefore, even if the insurance company tells you there is no coverage, it is advisable to contact an experienced insurance attorney before you sign any documents or waive your rights by failing to take prompt action. In Arizona and California, you must typically file any claim for bad faith against the insurer within two years. However, some claims have only a one-year window in which to act. It is critical that you consult with an attorney as soon as you have reason to believe your rights may be violated.

Schlesinger Conrad, pllc will be able to assist you by analyzing the policy, applying the policy language to the specific facts of your case, ensuring that the policy language meets the specific requirements required by law, and that the insurer is licensed to do business in your state. If you believe your insurance company is wrongly delaying or denying payment on your claim, please contact Schlesinger Conrad, pllc for a complete evaluation.