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	<title>Phoenix Insurance Bad Faith Attorneys | Policy Claim Lawyer Scottsdale, Arizona</title>
	
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		<title>Arizona Insurance Issues Plague Scottsdale and Phoenix Metro Homeowners</title>
		<link>http://www.azlegalcenter.com/2012/05/28/arizona-insurance-issues-plague-scottsdale-and-phoenix-metro-homeowners/</link>
		<comments>http://www.azlegalcenter.com/2012/05/28/arizona-insurance-issues-plague-scottsdale-and-phoenix-metro-homeowners/#comments</comments>
		<pubDate>Mon, 28 May 2012 13:21:35 +0000</pubDate>
		<dc:creator>the Firm</dc:creator>
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		<guid isPermaLink="false">http://www.azlegalcenter.com/?p=247</guid>
		<description><![CDATA[Do you really know what loss or damage your Scottsdale Arizona insurance homeowner policy will cover? Will your insurance policy compensate you sufficiently to replace damaged personal property and belongings in your Cave Creek or Carefree Arizona home? Will your Phoenix Arizona insurance policy cover all of the structural damage to your home, regardless of [...]]]></description>
			<content:encoded><![CDATA[<p><em>Do you really know what loss or damage your Scottsdale Arizona insurance homeowner policy will cover?</em></p>
<p><em>Will your insurance policy compensate you sufficiently to replace damaged personal property and belongings in your Cave Creek or Carefree Arizona home?</em></p>
<p><em>Will your Phoenix Arizona insurance policy cover all of the structural damage to your home, regardless of causation?</em></p>
<p><em>If you work from home, will your home office and expensive computer equipment upon which your livelihood depends be covered by your Fountain Hills Arizona insurance policy?</em></p>
<p>When you enter into an insurance policy agreement with an insurance company, you agree to pay insurance premiums and the <a href="http://www.azlegalcenter.com/homeowner-insurance/">homeowner insurance</a> company agrees to provide protection should a covered event occur. You would expect your insurance policy to cover home damage from fire, mold, roof damage, foundation cracks, water damage, hail damage, and theft. And when someone is injured on your property, you would expect your homeowners&#8217; insurance company to promptly pay any legitimate insurance claim, to protect you for a claim in excess of your insurance policy benefits, and to defend you in any resulting lawsuit over a disputed insurance claim.</p>
<p>&nbsp;</p>
<p><strong><em>Some of the Most Common Reason for Denial of Homeowners Insurance Claims</em></strong></p>
<p>The primary reason why homeowner insurance claims are denied is because the insurance policy didn’t cover the type of damage or loss that occurred. This can mean that the insurance policyholder either didn’t really understand the insurance policy terms, or was led to believe the insurance policy contained provisions for compensation over specific losses, damages, and repairs when in fact it did not.</p>
<p>Typically, an Arizona insurance policy for the homeowner will provide coverage for:</p>
<p><strong><em>●  Home property damage claims</em></strong></p>
<p><strong><em>●  Homeowner theft claims</em></strong></p>
<p><strong><em>●  Liability claims</em></strong></p>
<p><strong><em>●  Medical payment benefit claims</em></strong></p>
<p>Under each of these insurance policy provisions, you should read your homeowner insurance declaration, insurance policy, and insurance policy endorsements very carefully to understand the full scope of the insurance coverage provided.  The problem is that you probably won&#8217;t learn much from reading the policy unless you are an insurance claims attorney.  The comprehension level required to understand most insurance policies is slightly above that needed to understand Einstein&#8217;s theory of relativity. Insurance companies do this deliberately so that they can try to interpret the language to their advantage.</p>
<p>&nbsp;</p>
<p><strong><em>Practical Tips for Pursuing a Homeowners Insurance Claim</em></strong></p>
<p>Insurance can be boring and the process of getting your homeowners insurance claim fairly paid tedious.  To make matters worse, you usually have to steer through a complicated maze of endless claims forms.</p>
<p>The first thing you should know is our courts have generally held that where those incomprehensible insurance policies have unclear language, the language will be construed against the insurance company and in favor the insurance consumer.  So, if you are in a dispute with the insurance company, do not simply take the insurance company&#8217;s word for the meaning of certain language or phrases in your insurance policy.</p>
<p>Second, Arizona insurance law has adopted the &#8220;reasonable expectation&#8221; doctrine.  Although this can be a complicated legal theory with many nuances, it generally means that you get the coverage you expected, so long as your expectation was reasonable under the circumstances.  This insurance coverage may exist even if the insurance company attempts to exclude it through some fine print in the insurance policy that is to the contrary.</p>
<p>Third, most courts have held that exclusions in insurance policies must be phrased in plain, clear, and conspicuous language.  Most insurance claim denials are based upon exclusions &#8211; language usually on the last pages of your policy that attempts to take away the coverage that appears on the first pages of your policy. Many insurance consumers are not aware of these exclusions and many exclusion clauses are difficult to understand.  Because of this, most courts have created legal rules to aid the insurance policyholders.</p>
<p>Finally, if the insurance company denies your claim, the insurance consumer should demand a written explanation as to the basis for the denial.  Do not settle for a simple, verbal denial from the insurance claim adjuster.  Once you receive the insurance claim denial in writing with the basis for the denial, you should read your insurance policy again because you may not agree with the insurance company&#8217;s interpretation of the insurance policy language.  In short, make sure the denial of your insurance claim is legitimate.</p>
<p>&nbsp;</p>
<p><strong><em>When Your Scottsdale Arizona Insurance Claim Is Wrongfully Denied</em></strong></p>
<p>Beware! Insurance companies acting in bad faith may delay homeowner claims processing, underpay on claims, treat you and your family unfairly, offer unreasonably low settlements, and wrongfully deny Scottsdale and Phoenix Arizona insurance claims altogether.</p>
<p>If you suspect any of the following acts or omissions have occurred in the denial of your homeowner’s claim, then your Scottsdale and Phoenix Arizona insurance company may have violated the law:</p>
<p>●  While conducting its investigation, your insurer intimidates or harasses you and your family, or unreasonably disturbs your neighbors, friends, clients or co-workers.</p>
<p>●  Your insurer unnecessarily delays its investigation and neglects evaluating your claim.</p>
<p>●  Your insurer conducts its investigation, but then offers you an unreasonably low settlement figure, something far below the policy limits; or attempts to bully you into accepting a low-ball settlement just to put an end to the conflict.</p>
<p>●  Your insurer denies your claim for fire damage or theft by unfairly accusing you of insurance fraud, false claims, or even arson.</p>
<p>●  Your insurer denies all or part of your claim without ever clearly explaining the reason why it was rejected.</p>
<p>&nbsp;</p>
<p><strong><em>You Don’t Have to Fight a Bad Faith Insurer on Your Own!</em></strong></p>
<p>Get help from <strong><a href="http://www.azlegalcenter.com/firm-overview/">Shane L. Harward</a></strong> – he’s the Scottsdale attorney who has been challenging insurance companies that violate insurance policyholders’ rights since 1995. When you call 480.874.2918, you’ll get a FREE initial telephone consultation about your homeowner insurance claim to see if we might assist you. Shane L. Harward will aggressively challenge any bad faith insurer’s unscrupulous tactics so you get the full compensation you deserve.</p>
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		<title>Phoenix Insurance Bad Faith Attorney Discusses INSURANCE BAD FAITH DAMAGES</title>
		<link>http://www.azlegalcenter.com/2012/04/28/phoenix-insurance-bad-faith-attorney-discusses-insurance-bad-faith-damages/</link>
		<comments>http://www.azlegalcenter.com/2012/04/28/phoenix-insurance-bad-faith-attorney-discusses-insurance-bad-faith-damages/#comments</comments>
		<pubDate>Sat, 28 Apr 2012 13:20:33 +0000</pubDate>
		<dc:creator>the Firm</dc:creator>
				<category><![CDATA[Uncategorized]]></category>

		<guid isPermaLink="false">http://www.azlegalcenter.com/?p=245</guid>
		<description><![CDATA[Experienced Phoenix insurance bad faith attorneys like Shane L. Harward will seek different kinds of damages from the insurance company that acted in bad faith. If you are considering legal action against your insurer for bad faith intentional claim denial, unreasonable delay or nonpayment on a claim, and so on, then this article is for [...]]]></description>
			<content:encoded><![CDATA[<p>Experienced Phoenix insurance bad faith attorneys like <a href="http://www.azlegalcenter.com/firm-overview/">Shane L. Harward</a> will seek different kinds of damages from the insurance company that acted in bad faith. If you are considering legal action against your insurer for bad faith intentional claim denial, unreasonable delay or nonpayment on a claim, and so on, then this article is for you.</p>
<p>In today’s post we’ll talk about the types of damages you may expect to recover in a bad faith insurance lawsuit: <em>contract based damages, emotional distress damages, punitive damages, and attorneys&#8217; fees</em>.</p>
<p>&nbsp;</p>
<p><strong><span style="text-decoration: underline;">Arizona Revised Jury Instructions (Civil) Fourth Edition &#8211; Insurance Bad Faith</span></strong></p>
<p><strong>INSURANCE COMPANY DUTY OF GOOD FAITH AND FAIR DEALING</strong></p>
<p>&nbsp;</p>
<p><strong><span style="text-decoration: underline;">INSURANCE BAD FAITH</span></strong></p>
<p><strong><em>Duty of Good Faith and Fair Dealing In Insurance Policy</em></strong></p>
<p>There is an implied duty of good faith and fair dealing in every insurance policy.</p>
<p>To prove that an insurance company breached the duty of good faith and fair dealing, the insured must prove: (1) the insurance company intentionally denied the claim, failed to pay the claim, or delayed payment of the claim without a reasonable basis for such action; and (2) the insurance company knew that it acted without a reasonable basis, or the insurance company failed to perform an investigation or evaluation adequate to determine whether its action was supported by a reasonable basis.</p>
<p>&nbsp;</p>
<p><strong><span style="text-decoration: underline;">INSURANCE BAD FAITH </span></strong></p>
<p><em>Measure of Damages For Insurance Company&#8217;s Breach of Duty of Good Faith and Fair Dealing</em></p>
<p>If you find that the insurance company is liable to their insured for breaching the duty of good faith and fair dealing contained within the insurance policy, you must then decide the full amount of money that will reasonably and fairly compensate the insured for each of the following elements of damage proved by the evidence to have resulted from the insurance company&#8217;s breach of the duty of good faith and fair dealing: (1) The unpaid benefits of the policy; (2) Monetary loss or damage to credit reputation experienced and reasonably probable to be experienced in the future; and (3) Emotional distress, humiliation, inconvenience, and anxiety experienced, and reasonably probable to be experienced in the future.</p>
<p>&nbsp;</p>
<p><strong><em>●  Contract Based Damages &#8211; Unpaid Benefits Of The Policy and more</em></strong></p>
<p>The plaintiff (insurance consumer) who is successful in a lawsuit against the defendant insurance company can recover the benefits under the policy terms. These damages have their legal basis in breach of contract. The insurance policy is contractual in nature and binds the parties, the insurance consumer (who pays the premiums) and the insurance company (who provides benefits on the occurrence of certain events). <em>The plaintiff can also recover losses that were a consequence of the insurer’s bad faith claim denial. </em>These consequential damages are considered foreseeable, meaning the insurer should have anticipated that the insured would suffer these consequences when it breached the policy agreement and failed to pay on a claim.</p>
<p>&nbsp;</p>
<p><strong><em>●  Emotional Distress, Humiliation, Inconvenience, and Anxiety Damages</em></strong></p>
<p>Recovery for emotional distress has its basis in tort law or personal injury law. <em>Inconvenience, suffering, humiliation, anxiety, and mental pain associated with a substantial invasion of the insured’s property interests characterize emotional distress insurance damages.</em> The plaintiff insurance consumer can recover emotional distress damages when his or her property rights were interfered with as a result of the insurance company&#8217;s bad faith failure to pay on the owed insurance benefits.</p>
<p>&nbsp;</p>
<p><strong><em>●  Punitive Damages</em></strong></p>
<p>As with emotional distress, recovery for punitive damages has its basis in personal injury law. These damages go to the issue of a intentional bad faith breach of the insurer’s covenant of good faith or the insurance company&#8217;s conscious disregard of harm to an insurance consumer. <em>Punitive damages are meant to punish and deter future instances of such bad faith behavior.</em> As Phoenix insurance bad faith attorneys know, it takes more than simple negligence or failure to investigate the claim on the part of the insurer to prevail on a claim by the insured for punitive damages. But when the insurer was motivated by evil intent to cause harm to the insured, knew that it was creating a substantial risk of harm to the insured, had reckless, conscious disregard for the insured, or was overtly dishonest or fraudulent, among other things, then punitive damages may be awarded.</p>
<p>&nbsp;</p>
<p><strong><em>●  Attorneys Fees</em></strong></p>
<p>The statute controlling the recovery of attorneys fees on contested insurance contract claims is A.R.S. § 12-341.01. As applied to lawsuits to recover from acts of bad faith by an insurer, the plaintiff (insurance consumer) may seek to recover the costs of hiring an attorney when the insurer unreasonably withheld benefits under an enforceable insurance policy.</p>
<p>&nbsp;</p>
<p>At the <strong>Law Offices of Shane L. Harward</strong>, our insurance bad faith attorney represent clients throughout Phoenix and its surrounding Arizona communities including Tempe, Mesa, Scottsdale, Chandler, Peoria, Glendale, and Paradise Valley, to name only a few. When you need a strong legal advocate – when you want to know what kinds of damages your case may involve – call <strong>480.874.2918</strong> or <a href="http://www.azlegalcenter.com/contact-us/">email</a> us for a free confidential telephone consultation.</p>
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		<title>Insurance Consumer Attorney – Arizona Residents Battle Bad Faith Insurance Companies</title>
		<link>http://www.azlegalcenter.com/2012/03/28/insurance-consumer-attorney-%e2%80%93-arizona-residents-battle-bad-faith-insurance-companies/</link>
		<comments>http://www.azlegalcenter.com/2012/03/28/insurance-consumer-attorney-%e2%80%93-arizona-residents-battle-bad-faith-insurance-companies/#comments</comments>
		<pubDate>Wed, 28 Mar 2012 13:19:20 +0000</pubDate>
		<dc:creator>the Firm</dc:creator>
				<category><![CDATA[Claim Settlement Practices]]></category>
		<category><![CDATA[Insurance Company Bad Faith & Violations of Insurance Consumer Fraud / Unfair Practices Statutes]]></category>

		<guid isPermaLink="false">http://www.azlegalcenter.com/?p=243</guid>
		<description><![CDATA[When was the last time you purchased an insurance policy? Did you get explanations that were fully comprehensible to you and not so much “insurance legalese”? Did you take time to carefully read through the printed policy terms before you signed and paid the premium? Did you feel free to negotiate with the insurance agent [...]]]></description>
			<content:encoded><![CDATA[<p>When was the last time you purchased an insurance policy? Did you get explanations that were fully comprehensible to you and not so much “insurance legalese”? Did you take time to carefully read through the printed policy terms before you signed and paid the premium? Did you feel free to negotiate with the insurance agent on a policy that really met your needs and the needs of your family? Did you get to bargain for the insurance policy language you preferred or did the insurance company offer you an insurance policy to either take or leave without any input from you on the insurance policy language? If not, you are not alone. Most individuals rely exclusively on their insurance agent’s verbal assertions, descriptions, and promises about what the policy will cover.</p>
<p>Did you know enough about the policy terms to allow you to <a title="Insurance Comparison Tool From Office of Public Insurance Counsel Texas Department of Insurance" href="http://www.opic.state.tx.us/policy-comparisons/how-to-use-the-comparison-tool" target="_blank">comparison shop </a>for a better deal with a different insurer? According to our <a href="http://www.azlegalcenter.com/insurance-bad-faith-overview/">insurance bad faith attorney, Arizona</a> consumers seldom get detailed answers to their questions about policy coverage before they enter into the insurance contract. Arizonans typically fill-out the insurance application, dutifully pay the premium, and then place the written declaration of insurance away in a file or safe box. The only time the policyholder reviews the coverage is following an accident, property loss, emergency hospitalization, or some other incident. When the insurance consumer finally sits down to read the insurance policy, they will discover that it is not easily understood.</p>
<p><strong>From an Insurance Bad Faith Attorney, AZ Consumers Should Always Seek an Independent Legal Opinion</strong></p>
<p><a href="http://www.azlegalcenter.com/firm-overview/">Shane L. Harward</a> knows that, as a practicing insurance attorney, Arizonans routinely purchase insurance without thoroughly investigating the coverage details presented in the policy.</p>
<p><em>The most important aspect of any insurance policy is what it will and will not cover.</em> Most claims denials are based upon exclusions in the insurance policy. Exclusions usually appear on the last several pages of the insurance policy and attempt to take away the coverage that appears on the first couple pages of the insurance policy.  Many insurance consumers are unaware of these exclusions and frankly, the exclusions are usually difficult to understand even if the insurance consumer is aware of them.</p>
<p>Unfortunately, most policyholders don’t find out what is actually covered until they file a claim. After paying premiums for years, sometimes decades, when Arizona insurance consumers actually file bona fide insurance claims they may be notified by their insurers that the policies bought and paid for don’t cover their medical expenses or damages originally thought. When you don’t really understand your policy provisions, how will you know if your insurer wrongfully denies your claim? You need an independent legal opinion to determine if the claim denial was violates Arizona&#8217;s duty of good faith and fair dealing.</p>
<p>Compounding the problem, Arizona residents who lack a clear understanding of their insurance policy coverage are much more vulnerable to the wrongful denial of claims. Those consumers may not know how to challenge their insurance company’s bad faith refusal to pay insurance benefits. And in some cases, the insurance company will attempt to rescind, or cancel, the policyholder’s insurance altogether in a blatant refusal to cover medical expenses from illness, injury, or hospitalization. Insurance consumers often believe they have no rights to insurance proceeds when insurers, acting in bad faith, pull out all the stops to avoid paying on legitimate claims.</p>
<p>Although the insurance policy represents a contract between the insurer and the insured, insurance policies are what the law calls adhesion contracts because the policy language is not subject to bargaining by equally positioned parties. Insurance consumers are almost always in the weaker bargaining position and take what is offered. The insurance company is at a distinct bargaining advantage, and they know it. They are the insurance experts. They draft the insurance policies. They investigate the claims. They control the money. They decide how much to pay or not pay. If you suspect that your insurance company is acting in bad faith and breaching the terms of your insurance policy agreement, that’s when you need aggressive legal representation and advocacy.</p>
<p><strong>Your Bad Faith Insurance Attorney in Arizona</strong></p>
<p>Do you feel pressed or intimidated into accepting less than what you feel that your insurance company agreed to pay under the insurance policy? When your insurer has rejected your claim or minimized coverage for your losses, call <strong>Shane L. Harward – Insurance Bad Faith Attorney</strong>, Arizona – at <strong>480.874.2918</strong>.  Don’t let the insurance company double-talk you out of the full value of your legitimate claim. When you suspect bad faith on the part of your insurer, <a href="http://www.azlegalcenter.com/contact-us/">contact</a> the <strong>Law Offices of Shane L. Harward, PLC</strong>, today and protect your rights to full recovery.</p>
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		<title>AZ Insurance Attorney Reviews ERISA’s Impact on Health, Life, and Disability Claims</title>
		<link>http://www.azlegalcenter.com/2012/02/28/az-insurance-attorney-reviews-erisa%e2%80%99s-impact-on-health-life-and-disability-claims/</link>
		<comments>http://www.azlegalcenter.com/2012/02/28/az-insurance-attorney-reviews-erisa%e2%80%99s-impact-on-health-life-and-disability-claims/#comments</comments>
		<pubDate>Tue, 28 Feb 2012 15:53:29 +0000</pubDate>
		<dc:creator>the Firm</dc:creator>
				<category><![CDATA[ERISA]]></category>

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		<description><![CDATA[The Employee Retirement Income Security Act (ERISA) became federal law in 1974 and has been an obstacle to workers’ life, health, and disability insurance claims ever since. 29 U.S.C.S. § 1001. ERISA was passed to protect employees by setting standards for their employment pension plans and health and welfare benefit plans. Although ERISA doesn’t mandate [...]]]></description>
			<content:encoded><![CDATA[<p>The <em>Employee Retirement Income Security Act </em>(ERISA) became federal law in 1974 and has been an obstacle to workers’ life, health, and disability insurance claims ever since. 29 U.S.C.S. § 1001.</p>
<p>ERISA was passed to protect employees by setting standards for their employment pension plans and health and welfare benefit plans. Although ERISA doesn’t mandate the provision of employee pension plans or welfare benefit plans, if the employer does offer such plans to its employees, then it must comply with ERISA funding and coverage requirements.</p>
<h2>COBRA and HIPAA Are Part of ERISA</h2>
<p>You may not be familiar with every ERISA provision, but you’ve probably heard or made use of COBRA (the Consolidated Omnibus Budget Reconciliation Act of 1985). As any Arizona insurance attorney will explain, COBRA gives certain employees and related beneficiaries the right to continue with the employer’s insurance coverage when, for example, their job with the company was terminated.</p>
<p>Another important amendment to ERISA came in the form of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Among other things, HIPAA protects certain employees with pre-existing medical conditions – insurers cannot refuse coverage for these workers.</p>
<h2>The Road to Hell Is Paved with Good Intentions</h2>
<p>ERISA, as a federal law, preempts state laws without providing a useful, reasonable substitute when insurers wrongfully reject insurance consumers’ claims. Your Arizona insurance attorney knows that under state laws like Arizona’s bad faith insurance laws there would be swift and painful financial consequences for an insurer’s fraudulent denial of a consumer’s insurance claim. By punishing insurers, state laws provide a strong deterrent against offending bad faith insurer acts and omissions.</p>
<p>But because of federal preemption of <a title="Home" href="http://www.azlegalcenter.com/">Arizona&#8217;s bad faith laws</a>, ERISA hurts employees with respect to health and welfare insurance claims. When the insured sues the insurer for failure to pay on a legitimate claim, the remedies available under ERISA are minimal and, more often than not, will never approach making the worker whole again.</p>
<p>Under ERISA, if an insurer unreasonably delays or denies insurance policy claims, the most the insurance policyholder can recover is the insurance benefits owed. The court is allowed to award, but is not required to award, attorneys&#8217; fees and interest. If the insured had any consequential damages (that is, she lost her home to foreclosure because the insurance company unreasonably refused to pay timely disability benefits, for example), then that is the insured’s problem, even though the insurer’s bad faith refusal to pay on a valid claim was the direct cause of nonpayment on the mortgage and subsequent foreclosure. Damages for emotional distress, punitive damages, and damages for any other losses caused by the insurance company&#8217;s proven bad faith conduct are not available to an insurance consumer under ERISA.</p>
<p>This is the result that an <a title="Firm Overview" href="http://www.azlegalcenter.com/firm-overview/">experienced Arizona insurance attorney </a>will expect from an ERISA bad faith case:</p>
<p>The employee becomes disabled and can no longer work. He files a claim for disability benefits. The insurer wrongfully rejects his claim. He sues the insurer. In the interim, he files for bankruptcy protection from creditors. Years later, the employee wins the lawsuit. The insurer is ordered to pay the benefits it wrongfully denied. If the insured is fortunate, the judge will order his attorneys fees paid by the insurance company, too. But that’s all. In addition to coping with a disability, the worker’s financial life is shattered.</p>
<h2>What Incentive Is There for Any Health, Life, or Disability Insurer to Pay on a Claim?</h2>
<p>The answer from an Arizona insurance attorney is simple: None. Because insurance companies know that their liability for insurance claims subject to ERISA is limited to what they would owe if they paid the claim voluntarily and properly, they have little incentive to treat their insurance policy holders fairly and to pay the benefits owed. Instead, ERISA creates a strong incentive for insurance companies to refuse to pay insurance claims and to force insurance policyholders to file lawsuits. Insurers are not impartial benevolent trustees; they are businesses under pressure to turn very large profits for shareholders. Paying out on claims is the antithesis of insurance profits.</p>
<p>Under ERISA, these health, life, and disability insurers face no meaningful consequences and certainly no punishment for fraudulent bad faith refusals to pay on claims. The insurer can blatantly, fraudulently, wrongfully deny a claim and, should it lose the civil lawsuit, it knows full well that the only possible repercussions are paying what it originally promised to pay under the policy. Maybe it will have to pay the insured’s attorneys fees, a matter that is discretionary with the judge.</p>
<p>To make matters worse for the insured, ERISA also makes it exceedingly difficult for the insurance policyholder to win the lawsuit. There is no right to a jury trial in ERISA litigation – these are bench trials before a judge. Furthermore, discovery and admissibility of evidence is essentially limited to that which the insurer included in its claim file. In almost all ERISA cases, the court simply conducts a review of the administrative record that was before the insurance company and makes its decision completely on what information is in that record. Sometimes the insurance consumer can convince the court to hear additional evidence, but that is rare. This means the insurance policyholder does not get to tell his/her story to the judge and the insurance employees who wrongfully rejected the claim never have to testify. Lastly, because the insurance policy typically gives the insurer complete discretion over the decision to pay on a claim, at trial the plaintiff must prove that the insurer’s decision to refuse the claim was “arbitrary and capricious” – a fancy way of saying “completely off the wall.”</p>
<h2>Insurance in Name Only Under ERISA</h2>
<p>ERISA is extremely harmful to insureds, the preemption of state bad faith insurance and other laws has created a no-win situation for injured consumers. These employees are treated unfairly by workplace insurers who in bad faith deny claims without any risk of meaningful consequences. If your employer provides you with life, health, or disability insurance, then you are at the mercy of your insurer and ERISA. Be mindful that the insurer has every reason to deny your claim for any reason. If you sue and actually prevail at a bench trial, you’ll get the benefits you were denied, maybe attorneys fees, but nothing more.</p>
<h2>Some Employees Are Not Subject to ERISA</h2>
<p>The &#8220;good&#8221; news is that only about 85 percent of Americans who have group health insurance benefits through their employer are subject to the prohibitions of ERISA. Those not subjected to ERISA restrictions are individuals who work for governments (school teachers, police officers, etc.), churches, and with private insurance. These are the only people who have the right to bring a lawsuit for complete damages caused by their healthcare insurance provider&#8217;s bad faith claims handling practices. Everyone else can sue only for the cost of the treatment the insurance company was supposed to pay in the first place.</p>
<h2>Contact Shane L. Harward, an AZ insurance attorney, for help (480) 874-2918</h2>
<p>The important thing to know is that ERISA is very sticky subject to which many grey areas attach. If you feel you may fall into one of these grey areas and need help, it is important that you conact an insurance attorney as soon as possible.</p>
<h2>Contact your Congressional Representatives</h2>
<p>If you feel that federal law should not operate to encourage insurance companies to wrongfully refuse to pay legitimate insurance claims, we urge you to contact your representatives in Congress and to let them know you would like to see ERISA amended to allow state law to control lawsuits against bad faith insurance companies. The restrictions of ERISA, a program meant to help Americans, is unfairly turning honest citizens into desperate victims. ERISA should not give immunity to bad faith, dishonest insurance companies.</p>
<p>For any interesting law review article on the <a title="Revictimization of Personal Injury Victims By ERISA Subrogation Claims" href="http://erisawithprofessorbaron.com/wp-content/uploads/Revictimization-of-Personal-Injury-Victims-By-ERISA-Subrogation-Claims-Creighton-Law-Review.pdf" target="_blank">Revictimization of Personal Injury Victims by ERISA Subrogation Claims</a>.</p>
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		<title>Phoenix Insurance Bad Faith Attorneys – Review of Unfair Claim Settlement Practices</title>
		<link>http://www.azlegalcenter.com/2012/01/19/insurance-bad-faith-attorneys-%e2%80%93-phoenix-review-of-unfair-claim-settlement-practices/</link>
		<comments>http://www.azlegalcenter.com/2012/01/19/insurance-bad-faith-attorneys-%e2%80%93-phoenix-review-of-unfair-claim-settlement-practices/#comments</comments>
		<pubDate>Thu, 19 Jan 2012 21:02:53 +0000</pubDate>
		<dc:creator>the Firm</dc:creator>
				<category><![CDATA[Claim Settlement Practices]]></category>

		<guid isPermaLink="false">http://www.azlegalcenter.com/?p=212</guid>
		<description><![CDATA[Unless you’ve been treated unfairly by an insurance company and sought representation with an insurance bad faith attorney in Phoenix Arizona, cases of unfair claim settlement practices are probably a bit of a mystery to you. To clear up a few misconceptions about what an unfair insurance claim settlement practice actually is in Arizona, we start with some [...]]]></description>
			<content:encoded><![CDATA[<p>Unless you’ve been treated unfairly by an insurance company and sought representation with an <a title="Phoenix Insurance Bad Faith Attorney" href="http://www.azlegalcenter.com/firm-overview/">insurance bad faith attorney in Phoenix Arizona, </a>cases of unfair claim settlement practices are probably a bit of a mystery to you. To clear up a few misconceptions about what an unfair insurance claim settlement practice actually is in Arizona, we start with some of those unfair practices described under A.R.S. § 20-461 and Ariz. Admin. Code R20-6-801 (Arizona&#8217;s Unfair Claims Settlement Practices Act).</p>
<p>Phoenix, Scottsdale, Flagstaff, Tucson, etc. residents should be aware of the following 15 insurance practices (there are others, too) – all of which can be considered <a title="Failure to Investigate and Fairly Evaluate Claim" href="http://www.azlegalcenter.com/failure-to-investigate-and-fairly-evaluate-claim/">unfair claim settlement practices</a> in Arizona:</p>
<p>1. MISREPRESENTING your insurance policy’s provisions.</p>
<p>2. FAILING to acknowledge and act reasonably when notified of an insurance claim, or <a title="Failure to Investigate and Fairly Evaluate Claim" href="http://www.azlegalcenter.com/failure-to-investigate-and-fairly-evaluate-claim/">unreasonable delay</a> in investigating and processing the insurance claim.</p>
<p>3. TAKING too much time to affirm or deny an insurance claim.</p>
<p>4. REFUSING to pay an insurance claim without first conducting a reasonable investigation.</p>
<p>5. FAILING to reasonably explain the facts or laws that support denial of the insurance claim or offer of compromise.</p>
<p>6. LACKING good faith in providing a fair and equitable settlement when clearly liable; or attempting to influence a settlement under “Part A” of the insurance policy, for example, by delaying payment when clearly liable under “Part B.”</p>
<p>7. MAKING the insured sue to recover what was due under the insurance policy.</p>
<p>8. FAILING to have standards in place to investigate insurance claims.</p>
<p>9. ATTEMPTING to settle for less than a reasonable person would believe he or she was entitled to based on the insurance company&#8217;s ads and printed material.</p>
<p>10. RELYING on an altered insurance application when done without the insured’s knowledge or consent, for the purpose of settling an insurance claim.</p>
<p>11. FAILING to include a statement with insurance claims payments explaining the coverage that triggered those payments.</p>
<p>12. THREATENING an insurance claimant with the insurer’s policy of appealing arbitration awards to influence an insured into low-ball compromises and settlements of an insurance claim.</p>
<p>13. DEMANDING duplicate information during the claim investigation by requiring a preliminary claim report followed by a formal proof of loss form with substantially the same information – a tactic meant to delay investigation and payment of an insurance claim.</p>
<p>14. FAILING to pay the medical provider for diagnosis and treatment when the insurer is liable under the insurance policy.</p>
<p>15. DENYING a driver’s claim under a motor vehicle policy solely because the insured had a medical condition that could have affected his or her driving ability.</p>
<p>Have you or a member of your family experienced one of the unlawful insurance practices described in this post? If you believe so, then you need to take action to protect your legal rights.</p>
<p>Call the Law Offices of Shane L. Harward today at 480.874.2918 for a free initial telephone consultation with an insurance bad faith attorney (Phoenix and Scottsdale locations). Peace of mind alone is well worth the call!</p>
<p>&nbsp;</p>
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		<title>Nationwide is “Not” on Your Side</title>
		<link>http://www.azlegalcenter.com/2011/10/28/nationwide/</link>
		<comments>http://www.azlegalcenter.com/2011/10/28/nationwide/#comments</comments>
		<pubDate>Fri, 28 Oct 2011 22:24:41 +0000</pubDate>
		<dc:creator>S.Harward</dc:creator>
				<category><![CDATA[Insurance Company Bad Faith & Violations of Insurance Consumer Fraud / Unfair Practices Statutes]]></category>

		<guid isPermaLink="false">http://azlegalcenter.com/?p=1</guid>
		<description><![CDATA[Well that&#8217;s what two of their insurance policy holders think. Here is an example of the type of insurance bad faith claim I routinely handle. The case involves Nationwide Insurance and highlights the poor treatment that two insurance policy holders received from them&#8230; &#8220;At the beginning of a long awaited family trip to Idaho in [...]]]></description>
			<content:encoded><![CDATA[<p><em>Well that&#8217;s what two of their insurance policy holders think</em>. Here is an example of the type of insurance bad faith claim I routinely handle. <em>The case involves Nationwide Insurance and highlights the poor treatment that two insurance policy holders received from them&#8230;</em></p>
<p>&#8220;At the beginning of a long awaited family trip to Idaho in September of 2006, Ms. Laux and her mother, Ms. Brown, were the victims of a high-speed, hit-and-run collision. Ms. Laux and Ms. Brown were forced to file an uninsured motorist claim with their insurance company, Nationwide Insurance Company of America / Allied Insurance Company. Based upon Ms. Laux&#8217;s and Ms. Brown&#8217;s experience, it was their opinion that the advertising slogan of &#8220;Nationwide on Your Side&#8221; may be an effective marketing campaign with no substance when a valid claim is attempted to be resolved by those who pay premiums to Nationwide Insurance Company.</p>
<p>Just a few miles from the Phoenix, Arizona (Sky Harbor) airport, a vehicle traveling approximately 90-95 miles per hour smashed into the back of Ms. Laux&#8217;s and Ms. Brown&#8217;s vehicle, and fled the scene of the collision. Ms. Laux&#8217;s vehicle suffered over $10,000.00 in property damage and both Ms. Laux and Ms. Brown were injured. Because this family trip had been planned for several months and was extremely important for not only Ms. Brown, but her daughters (Ms. Brown had two daughters besides Ms. Laux) as well, Ms. Laux and Ms. Brown attempted to continue on with the family trip as planned. Shortly after arriving in Idaho, because the pain became so severe, Ms. Laux and Ms. Brown sought treatment at an Idaho Urgent Care facility. At that time, Ms. Laux&#8217;s main problem was noted as neck and low back pain. Ms. Brown suffered from pain in her neck, back, and right shoulder. The Urgent Care doctor prescribed anti-inflammatory and pain medication for both Ms. Laux and Ms. Brown and instructed them to follow up with their primary care physician when they returned home to Arizona. Ms. Laux and Ms. Brown followed up with their primary care physician at the Mayo Clinic and Hospital. Ms. Brown suffered from severe low back pain for over two years and tried multiple rehabilitative efforts including therapy, modalities, manual techniques, exercise instruction, and SI joint injections. Ms. Brown to this day continues to suffer from severe low back pain which at times radiates down her right side. Ms. Brown incurred approximately $6,000 in medical expenses because of treatment related to this incident.</p>
<p>Prior to this collision, Ms. Brown was an extremely healthy, active, and independent 82-year old mother, grandmother, and great-grandmother. Sadly, Ms. Brown not only lost her health and activity, but her independence. Ms. Brown regularly volunteered at a local elementary school and assisted one of the first grade teachers. This volunteer work was incredibly important to not only Ms. Brown, but also to all the children. Following the collision, Ms. Brown tried to assist with her first-grade class but was unable to do so because of the severe back pain.</p>
<p>Ms. Laux suffered from cervical pain, pain in the mid to low thoracic area, and increasing pain and instability to her left knee. Ms. Laux had extensive treatment including prescription medication, physical therapy, and two surgeries on her left knee. Ms. Laux incurred approximately $38,000.00 in medical expenses because of the treatment related to this incident.</p>
<p>Nationwide Insurance Company assigned adjuster Courtney Martin to handle the uninsured motorist claim. Nationwide refused to consider the injuries to Ms. Laux&#8217;s knee as part of the claim. Nationwide also refused to explain the factual or legal basis for its position and during the claim, Ms. Martin misrepresented conversations she had with Ms. Laux and Ms. Brown.</p>
<p>On November 28, 2007, Nationwide offered Ms. Laux $8,190.00 to settle Ms. Laux&#8217;s injury claim and $6,194.00 to settle Ms. Brown&#8217;s injury claim. Ms. Martin represented that these offers were based, at least in part, on Nationwide&#8217;s use of a nurse practitioner evaluation. Despite multiple requests, Nationwide refused to put the factual and legal basis for its evaluations in writing and refused to disclose the nurse practitioner report upon which it apparently relied. Instead, on February 26, 2008, Nationwide increased the offers to $12,660.36 for Ms. Laux and $9,471.46. Again, Nationwide refused to disclose to its insureds the basis for these offers and its change in position. Thus, Ms. Laux and Ms. Brown were forced to request arbitration pursuant to their insurance contract with Nationwide Insurance Company.</p>
<p>Ms. Laux and Ms. Brown requested arbitration on March 12, 2008, but Nationwide did not provide the name of its attorney until June 9, 2008 or its arbitrator until June 16, 2008. As part of the arbitration process, Nationwide hired a well-known defense medical examiner, Dr. Ronald Lampert, to examine and issue a negative report against Ms. Laux. Dr. Lampert issued his standard report calling Ms. Laux a &#8220;symptom exaggerator.&#8221; Dr. Lampert testified on behalf of Nationwide during the arbitration hearing. Dr. Lampert claimed to have performed testing on Ms. Laux that the arbitrators determined did not take place during his examination. Luckily, the examination was videotaped.</p>
<p>Interestingly, a couple days prior to the scheduled arbitration hearing on October 23, 2008, Nationwide presented, once again without any explanation as to the change in its evaluation, an offer that was nearly twice what it had previously offered on these claims. The arbitration was completed on October 23, 2008.</p>
<p>Ms. Brown was awarded $106,000.00.<br />
Ms. Laux was awarded $163,000.00.</p>
<p>In addition, Nationwide Insurance Company paid $30,000.00 and $55,000.00 respectively for extra-contractual, insurance bad faith damages.&#8221;</p>
<p><strong>Warning:</strong> <em>Case decisions are often subject to further review by other courts and thus may be affirmed, overturned, or modified in later proceedings; therefore the reader should exercise caution in the reading and interpretation of these cases as the current status of case law and/or statutory law may have changed by the time you read this. Please consult with a licensed attorney in the proper jurisdiction before you take any action based on what you read on this or any other website.</em></p>
<p><a title="Arizona Insurance Bad Faith and Consumer Fraud Cases" href="http://www.azinjurycenter.com/PracticeAreas-InsuranceCompanyBadFaithAndInsuranceFraud.htm" target="_blank">Additional Representative Civil Cases involving Insurance Bad Faith and Consumer Fraud Allegations </a>are found here.</p>
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