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INSURANCE CLAIMS & LITIGATION



The Insurance Company Business Model


Insurance companies work on an interesting business model. They charge and collect premiums from their customers. Insurance companies pay out claims from their collection of premiums. The more insurance companies pay out in claims, the less profit they make.


While the average American struggles to make ends meet, insurance companies have posted record profits recently. For example, the CEO of Cigna earned in excess of 121 million dollars over the past five years in salary alone.


What does this mean for a consumer? Simply put, the less an insurance company pays you, the bigger its profit. As a routine matter, this means that insurance companies almost always nickel and dime and short-change persons making claims. Insurance companies have legions of attorneys working for them. You should have one on your side. Call now to speak with an experienced insurance attorney or insurance lawyer about your insurance claim.


Types of Insurance Claims


An insurance policy is a contract between an “insured” and the insurance company.  There are many types of policies that are issued by insurance companies, providing different types of coverage. This article covers some common areas. If you have questions about a policy, feel free to call an insurance attorney or insurance lawyer at Kane | Varghese.


a.  Fire Insurance Claims


Individuals or businesses may purchase fire insurance claims policies that cover fire damage or loss. Damage from fire to your home or business can be traumatic on several levels.  If your home was destroyed in a fire, you will have to deal with the trauma of losing your personal belongings, many of a nature that may never be replaceable.  If a business burns down in a fire, there can be dramatic effects on finances, cash flow, revenue and profits. If you have questions about a fire insurance claim, feel free to call an insurance attorney or insurance lawyer at Kane | Varghese.


b.  Roof Damage Claim, Tornado Claim, Storm Damage Claim, Hail Damage Claim, Water Damage Claim


Consumers can purchase insurance coverage, either through their commercial insurance policy or residential insurance policy for roof damage claims, tornado claims, storm damage claims, lightning damage claims, and hail damage claims or hurricane damage claims.  Water damage claims can arise from a leaky roof, burst interior plumbing or hot water heater that can cause substantial damage to property. If you have questions about a fire damage claim, roof damage claims, tornado claims, storm damage claims, lightning damage claims, and hail damage claims or hurricane damage claims or a water damage claim, feel free to call an insurance attorney or insurance lawyer at Kane | Varghese.


c.  Life Insurance Claims and Life Insurance Claim Litigation


Has a life insurance company wrongfully denied payment of proceeds to a beneficiary under a life insurance policy? If so, you may be entitled to bring suit against your life insurance company. Life insurance companies have a duty to pay the beneficiaries of a life insurance policy.  Typical grounds for non-payment under a life insurance policy include a “material misrepresentation” made by the policy holder to the life insurance company during the life insurance application process. The experienced insurance attorneys at the firm have successfully sued on behalf of property and policyholders and recovered against insurance companies in property insurance, life insurance, accident insurance and other insurance claims. If you have questions about a life insurance policy or denial of benefits under a life insurance policy, call an experienced life insurance attorney and lawyer at the Kane | Varghese Law Firm. We will fight for you.


d.  Bad Faith Insurance Claims & Litigation


If your insurance company is dragging its feet, refusing to be fair with you, or refusing to provide you fair and proper reimbursement for your fire damage insurance claim, roof damage insurance claim, tornado insurance claim, storm damage insurance claim, lightning damage insurance claim or hail damage insurance claim, call an experienced insurance attorney or insurance lawyer at the Kane | Varghese Law Firm.  The following is a list of potential reasons that may give rise to a bad faith claim against your insurance company.

- Failure to attempt to come to a fair and reasonable settlement when liability is clear

- Offering substantially less money to settle than the true value of the insurance claim

- Failure to promptly provide a reasonable explanation for denial of a insurance claim

- Failure to enter into any negotiations for settlement of the insurance claim

- Failure to respond to a time-limit demand in an insurance claim

- Failure to disclose insurance policy limits

- Unwarranted denial of coverage by an insurance company

- Failure to communicate pertinent information to the claimant

- Failure to conduct a reasonable investigation of the insurance claim

- Refusal to pay an insurance claim without investigating

- Failure to deny or pay the insurance claim within a reasonable period of time

- Failure to confirm or deny coverage within a reasonable period of time

The insurance attorneys and lawyers at Kane | Varghese have been fighting insurance companies for more than a decade to obtain fair insurance claim settlements for our clients. We are not afraid to take on the big insurance companies.

Strategies Used by Insurance Companies to Pay You Less on your Insurance Claim
          
Typically, insurance companies will try to cut corners by trying to allege that some portion of the structure doesn’t have to be torn down or redone, so that they can save on costs.  Some insurance companies maintain that a smoked out, blackened structure doesn’t affect the integrity of the structure and therefore a portion of a home or business does not need to be demolished and redone. Yet other insurance companies will try to delay and nickel and dime in the evaluation process hoping that the property owners will eventually be worn out in the war of attrition and delay and accept less than what they are actually owed.  A typical strategy used by insurance companies to lessen a payout is to argue that fire damaged personal property that includes smoke damage can be cleaned when it is obvious that any amount of cleaning will not restore the property to its original useable status. Insurance companies may try to limit payouts on the grounds of “wear and tear,” improper maintenance or faulty construction grounds. Many of the tactics described here are used to shortchange those insured when they try to make a roof damage claim, tornado claim, storm damage claim, lightning damage claim or hail damage claim. 


If you are dealing with an unfair insurance company or adjustor, call an experienced insurance attorney or lawyer at Kane | Varghese.


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