Articles Posted in Insurance Denial

Okay-Bone-240x300Motor vehicle accidents (“MVAs”) are extremely dangerous. An average mid-sized sedan weighs about one-and-a-half tons. Even when moving at relatively low rate of speed, the force of a one-ton collision is enormous. A head on collision is far worse. If a vehicle going 47 mph strikes another vehicle traveling 64 mph, the collision is of a similar magnitude to a vehicle traveling at 111 mph ramming into a concrete barrier. Modern safety features have dramatically reduced the risk of injury in a MVA, but there is little technological innovation can do to offset the impact of a high-speed head-on collision.

Some MVAs cause immediately life-threatening injuries. First responders take the injured directly to a hospital for critical care. However, other incidents may not cause injuries that require the same type of immediate life-saving intervention. The injured party will be offered the option to travel to a hospital in an ambulance, but instead of accepting emergency transport, the individual injured will decline for a number of reasons. He or she might feel embarrassed or ashamed of being in an accident; the cost of the ambulance service will cause financial hardship; the idea of taking an ambulance when not in a life-threatening situation may feel selfish; pride may play into the decision-making process; or the injured person may just not feel like they’ve suffered a severe enough injury to justify that level of attention.

While some of those who decline emergency transport may go directly to the emergency room by other means, many decide to wait and see their primary care physician. Others will not seek medical attention at all, or simply decide that the injury is not severe enough for pay for the office visit, waiting to see if the injury heals on its own. While financial concerns are valid—our system’s fundamental flaw is that seeking medical treatment can end in bankruptcy—it is always wise to see a doctor after an MVA.

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Neumann Law Group has a proven track record challenging insurance coverage denials. Today, more and more businesses are suffering extensive losses, either directly from the corona virus, or from governmental action shutting down operations to mitigate the public health risk. Many businesses have paid insurance companies premiums for years to ensure protection in the event of a business stoppage by purchasing business interruption and civil authority policies or riders. Now, when small businesses need the most help, insurance companies are not providing much needed assistance.

Nationwide, almost all insurers offering business interruption coverage or civil authority coverage have denied claims related to COVID-19. The two types of policies are interrelated. Business interruption coverage allow companies to hedge against certain losses when the business suffers physical damage or loss that interferes with its ability to operate. Civil interruption coverage generally allows recovery when a civil authority issues an order closing a business or interfering with normal operations.

First and foremost, if you don’t know whether your business has such coverage, call your agent and find out. Most policies require the insured to submit claims promptly, so making a timely claim is critical. The types of injury upon which business have filed claims include lost income due to business closure, lost income due to public knowledge of infections on premises, costs of sanitization and employee testing, and a host of other claims specific to particular businesses.

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