From the 'Lectric Law Library's Stacks
"Health nuts are going to feel awfully stupid someday, lying in hospitals dying of nothing." -Redd Foxx
Insurance companies have been fighting with their customers since the earliest days of the modern insurance industry, when merchants pooled their assets at places like Lloyd's of London to protect against individual cargoes being lost at sea. Disputes often center on what property is covered by insurance and what risks are insured against.
Relations have gotten even more contentious since the early 1980s, when the insurance industry started to become a self-service market. It began selling a growing percentage of policies directly to customers by mail, phone and even computer online systems. With the traditional middlemen - independent agents selling insurance - gradually squeezed out of this newly deregulated and competitive marketplace, consumers are forced to evaluate competing policies for themselves.
Companies have also cut back on customized coverage and now offer a few basic policies of each kind. Many customers have had problems dealing with these off-rack policies.
A little practical cynicism is in order here. Insurance companies - even the best ones - profit by not paying out claims. And even when they must pay, it's in their best interest to settle claims as cheaply as possible. The result is that most companies create a corporate culture of stinginess.
Essentially, insurance companies save money in two ways: they raise the amount they charge in premiums, and they build a lot of exclusions into the policies they sell.
In a competitive marketplace, especially one where insurance is sold directly to the public, raising premiums often means losing market share - something insurers understandably don't like. The alternative - packing their policies with fine print exclusions - has turned out to be far more palatable.
It's especially important to pay attention to the parts of a policy that deal with definitions and exclusions. Unfortunately, this isn't easy since they're the most mind-numbing aspects of a mind-numbing field. To give you a little guidance, here is a quick tour of the types of exclusions you should be wary of.
Personal insurance - covering your home, rented dwelling, personal property or car - usually excludes:
Many people whose claims are turned down under a policy exclusion get infuriated and sue their insurance company. It's often easy to find a lawyer to take such a case, because the companies have lots of money and get little sympathy from juries.
But relying on the court system should always be a last resort. An insurance company with lots of lawyers on the payroll is almost surely better positioned to litigate a long dispute than you are.
If you know the rules that courts use to decide these disputes, though, you may be able to negotiate a better settlement - and avoid court altogether.
Here are the important rules:
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