The attorneys at Louis Law Group will select and, in most cases, foot the bill for industry experts specialized in your type of claim to help you, the policyholder, build a formidable case.
From contractors to engineers and even freelance professionals, Louis Law Group hires only seasoned and experienced experts to comprehensively review your insurance claim. The use of professionals as expert witnesses differentiates Louis Law Group from the plethora of other insurance law firms out there.
The attorneys at Louis Law Group will thoroughly assess any claim and help policyholders receive their rightful benefits. Also, our first review of your insurance claim will cost you nothing. We act on behalf of policyholders, and represent them nationwide.
Attorneys at the Louis Law Group often work on a contingency basis. This means that we only get paid if you win your case. Typically, Louis Law Group will have to seek the services of industry professionals, amongst other resources, as the case progresses to help us build the best possible case on your behalf. The seasoned attorneys at Louis Law Group are fully aware that seeking the impartial and expert analyses of such experts can be the difference between a successful and unsuccessful claim. We are thoroughly committed to getting the maximum settlement for all our clients, and will generally advance most cost pre-settlements.
Louis Law Group demands that you provide the following documents, where possible:
For Commercial and Residential property claims:
For Healthcare Claims:
In the insurance industry, bad faith refers to a situation where contractual obligations to a policyholder aren’t met. Examples of bad faith include intentionally giving wrong information to a policyholder or failing to act in accordance with the typical industry standard.
This would heavily depend on the prevailing law that determines/interprets insurance practices and policies in your locale. The fact that an insured can file a bad-faith lawsuit against an insurance company helps ensures the impartial and prompt payment of benefits and claims when the insurance company has neglected to act. However, an insured must not consider bad faith as a route to getting a guaranteed payment from an insurance company. Generally, bad faith litigation offers a more favourable result when it is backed up by a previous court ruling. Bad faith often originates when an insurance company refuses to pay benefits that are applicable under a policy, or any other unfair behavior by the insurance company.
Whether a refusal to pay benefits escalates to bad faith mainly depends on why the insurer deems it fit to withhold benefits. When the insurer has a good reason not to effect the payment of benefits, this may not be termed a contractual breach or bad faith. Every case of withheld benefits isn’t necessarily bad faith; therefore, it is important that the case be carefully considered before a file for bad faith is made.
You must file a lawsuit against your insurer after a loss during the statute of limitations period. This time will vary based on the details of your policy and the state you reside in. If you would like swift legal redress regarding a claim, you should begin the process as soon as possible if you wish to receive your claim in full.
Usually, a defense counsel will claim fraud if a policyholder purposely refuses to answer a question at EUO. In such a scenario, the insurer can argue that the policyholder is breaching their obligation to cooperate. Most times, the insured may refuse to answer very sensitive or personal questions, but the insurer is allowed to thoroughly probe into specific areas in the course of their examination that may reveal any unclear information (e.g., how much the policyholder actually earns).
The stance of the court is often that the EOU is a contractual duty that must be adhered to before the insured can claim recovery. It is not unusual for the policyholder to be asked to answer questions regarding the actual loss or the circumstances regarding the loss.
Refusing to submit to an EUO is considered a violation of your contractual obligation with your insurer. An examination under oath is different from a deposition, since the former involves an agreement by contract where the policyholder is obligated to give accurate information on request to the insurer. During a deposition, no such demand exists. Therefore, depositions cannot take the place of an EUO.
Usually, property insurance policies will come with an appraisal provision that can be invoked by either the insured or insurer to ascertain the value of a loss. The responsibility of “valuation” is often termed by the court as a duty of the appraisal panel, and “coverage determinations” are determined by the court. The court isn’t explicitly clear on what can be classified as “valuation” (which can be verified through an appraisal) or classified as “coverage determination” (which must be defined by a court). Policyholders who feel that their claim has been partially underpaid or valued commonly opt for an appraisal provision, in a bid to evade the expense and time associated with litigation. However, one of the following answers is often given to the insured by the insurer:
Experiences from prior cases demonstrate the importance of policy interpretation. Policyholders must, therefore, pay attention to the following facts in first-party property claims:
This sort of policy exclusion/limitation is popularly described as the “wind-driven rain” exclusion. It is highly recommended that the insured is knowledgeable of the basic provision when reporting claims to their insurance company or giving an official statement of the loss
There are numerous aspects to be evaluated during the examination of losses and damages to your property. Were there any prior damages before the loss? Is the insurance policy only liable for losses and not damages? Can there be loss without damage? Was there any previous damage caused by any other factor (wear and tear)?
Usually, the property insurance proof of loss is often included in the formal claim, including:
This policy typically requests that the policyholder swear that the proof of loss is accurate. It also has to be signed by the insured. The timeframe for submitting a proof of loss will differ based on policy and state. Thus, you should confirm the exact permitted time limit for a proof of loss in your state. In some states and some instances, submitting a proof of loss after the allotted period can become a reason for the insurer to reject an otherwise valid proof of loss.
Once the claim has been filed, the insurer must instruct a licensed insurance adjuster to verify that the property of the insured can be restored to the condition it was in before the damage. As a policyholder, you are expected to peruse the policy and be aware of the demands of the requirements and applicable obligations in the case of a loss.
The Responsibilities of the Insurance Provider
The insurer must: