Law Office of Keith D. Miller

Insurance Law - An Overview

Most people own at least some type of insurance, such as auto, health, life, home, disability, fire/casualty, renters, title, marine, or long-term care insurance. Businesses and professionals often also take out insurance, including small business, liability, and workers compensation insurance. Insurance law primarily revolves around issues arising out of a contract between the insurance company and the insured party.  Our office has years of experience assisting insurance companies, individuals and businesses with contract interpretation and litigation.

 Role of Insurance Companies - The Insurer as an Underwriter

In an insurance policy or contract, the insurance company takes on the role of an underwriter, meaning the insurance company establishes and receives a premium for the period in which the insurance is provided. Premiums include the amount of money necessary to cover all costs, including paying proceeds on losses under the insurance policy, establishing legitimate contracts that conform with state and federal regulations, investigating legitimate claims, defending against fraudulent claims, and engaging in educational efforts to minimize loss. The insurance company then becomes personally liable to pay the proceeds of any loss under the insurance policy.

Coverage of Claims and Filing a Claim

Typically, an insurance policy includes specific requirements that an insured must follow in order to receive any proceeds from his or her policy. Many people never read their insurance policies, and when they must file a claim, they are surprised to learn that they have not followed important requirements. These requirements generally include guidelines regarding notice of a claim, timeliness in filing of a claim, proof of loss, appraisal, and prevention of subsequent damage. To prevent delay or denial of your claim it is also important to maintain good records of insured items, including receipts, warranties, and valuation documents. In addition, it is crucial that all insured parties understand and be aware of the specific requirements outlined in their insurance policies. To learn about your insurance company's requirements for filing a claim, contact your insurance company and request a copy of your insurance company's policies and procedures, as well as a copy of your specific policy.

If you need to file a claim, are having difficulties filing a claim with your insurance company, or have questions about coverage of your claim, contact our firm to schedule a consultation with an attorney.

Bad Faith and Refusal of Claims

Bad faith claims are situations where claimants sue the insurer for improperly denying valid claims. This cause of action has been adopted by most states to further protect insured individuals in their interactions with insurance companies. A bad faith cause of action is a combination of a tort and a contract claim. This action is based on a fundamental principal of contract law that there is an implied covenant of good faith and fair dealing on both sides of every contract. If you believe your claim has been wrongly denied or refused or that you have been the victim of a bad faith failure to pay a claim, contact an attorney at our firm for more information about your situation.

Duty to Defend and Defense of Claims

Generally, insurance policies include a clause that places the duty to defend an insured individual on the insurance company as long as the cause of action is covered by the policy. Insurance companies have a duty to defend an insured individual, even if an allegation is false, fraudulent, or groundless; however, in these situations, the insurance company may not have to pay out proceeds to the insured party based on the invalidity of the claim. If an insurance company fails to uphold its duty to defend an insured party against a third party claim, the insurance company may be held liable for the damages. If your insurance company has not upheld its obligation to defend you against a claim brought by a third party, contact an attorney at our firm for assistance.

 

The Law Office of Keith D. Miller serves clients throughout central New York and the Capitol District including Broome County, Cayuga County, Chenango County, Cortland County, Herkimer County, Jefferson County, Lewis County, Madison County, Monroe Montgomery County, Oneida County, Onondaga County, Ontario County, Oswego County, Otsego County, Saratoga County, Schuyler County, Seneca County, Lawrence County, Tioga County, Tompkins County, Yates County, Wayne County, as well as the cities of Syracuse, Watertown, Utica, Rochester, Binghamton, Ithaca, Lowville, and Oswego.

1000 7th North Street – Suite 120 – Liverpool, NY 13088 / Phone: (315) 701-5768 / E-mail / Fax: (315) 701-5770

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