Interpreting Insurance Contracts And Insurance Policies

HOUSTON GENERAL INSURANCE COMPANY; Inez Grant; Morehouse Parish School Board; Horace Mann Insurance Company and Lloyd Gray, Defendants-Appellants-Appellees.

I was looking in my mirror at the red and blue flashing lights. My stomach dropped and I was scared about what was going to happen. I had already been pulled over twice in the last week, once for running a stop sign, the second for speeding. It’s about 1am and only that time because of the day light savings. It is now passed my curfew.

HMOs are usually the least expensive health plans, offer predictable costs for health care, the least administrative paperwork, and cover preventive care (Barsukiewicz, Raffel, & Raffel, 2010). However, HMOs also restrict direct access to specialists by requiring referrals by a PCP, requiring patients to see a provider in the HMO network, and often not covering more costly procedures or care options, because care is managed to control excessive or unnecessary care. Providers gain if they provide less care (Austin & Wetle, 2012). This incentive could affect patient-provider trust.

One of the principal grounds for rejecting insurance claims is that the claim is not covered by the terms of the policy, or is specifically excluded. The rule that coverage provisions should be interpreted broadly and exclusion clauses should be interpreted narrowly is really just a corollary of the Contra Proferentem rule which applies in the event of ambiguity i.e. it is the insurer who likely drafted the insurance contract and construing coverage provisions broadly, or exclusion clauses narrowly, will be to the detriment of the insurer as the party who drafted the contract. The construction of exclusion clauses and coverage provisions helps justify the objective intention of the contract. This is the intention which the court considers, a reasonable person in the position of the contracting parties, would have had. It is submitted that coverage provisions should be broad and encompassing and exclusion clauses should be narrow. However, before such a conclusion is reached, this paper will aim to justify the reasoning behind such a claim analysing arguments for and against such a proposition, drawing upon the landmark case Darlington Futures Ltd v Delco Australia Pty Ltd to help relate the discussion to issues raised by such considerations.

Understanding your Medicare coverage can be a bit of a hassle. But it's important that you do understand your coverage, because it has a lot to do with your financial security. You should be aware of what you have covered in terms of medical expenses in terms of in patient, out patient, doctor's visits, and medications. That way you'll know what to expect if you use a lot of medications or end up going to the doctor, and you'll be able to arrange your finances accordingly.

David A. Goldmeier and Terry C. Goldmeier v. Allstate Insurance Company 337 F.3d 629 (6th Cir 2003) case supports our

State Farm has asked whether it has a duty to defend the insured pursuant to the insured’s homeowners policy. It is our opinion that State Farm has no duty to defend the insured under the insured’s homeowners policy. The insured’s homeowners policy entitled the insured to a defense for “a suit brought against an insured for damages because of bodily injury or property damage to which this coverage applies, caused by an occurrence.” In this case, these elements initially triggering the insured’s homeowners policy are likely satisfied. Nevertheless, the SECTON II – Exclusions section provides that the liability coverage does not apply to any of the fifteen exclusions specifically enumerated therein.

This case shows that the insurance company’s duty to deal in good faith does not extend to the plaintiffs who were not insured under the contract. Because there was no relationship with the insurer, the plaintiffs could not bring a direct action for bad faith against the insurance company to recover an amount in excess of the policy limits.

Obamacare is not universal healthcare. The United States actually has an extension of health insurance coverage that is the program we all call Obamacare. This extension of health insurance coverage is expected to cover an additional 26 million people by 2024. In understanding this concept, what we need to understand fully is that the United States does not have universal coverage. Obamacare does not eliminate uninsurance in America; instead, it cuts the number of people lacking coverage about in half. Even after Obamacare is fully implemented, budget forecasters still expect that 31 million Americans will lack insurance coverage which is a bigger group than the people buying coverage on the exchanges (Vox.com).

New Jersey is located in the northeastern and mid-Atlantic region of the US. The states that border New Jersey are: New York, Pennsylvania, Delaware, and the Atlantic Ocean. New Jersey is nicknamed the Garden State. New Jersey was home to Native Americans for over 2,800 years.

Insurable interest is an important and fundamental principle of insurance. For an insurance contract to be valid, the insured must possess an insurable interest in the subject matter of insurance. The insurable interest is the pecuniary interest whereby the policy holder is benefited by the existence of the subject matter and is prejudiced by its destruction. Thus, insurable interest must be actual and real and not arising out of mere expectation.

During my work as a medical scribe I had to sign a contract with a similar agreement. This contract was meant to teach me that my work was to assist the patient that came into the hospital and to have honor for the duties I was to be performing. Pride in the job I was performing and for those I wished to help allowed me to sustain this agreement and refrain from putting the personal information of patient’s in any unauthorized hands. My hope to become a good physician and to maintain integrity in my work was tested during my scribing days and this allowed me to work and uphold the professionalism that I possessed during work and in my everyday life.

"[a]n insurance company has a duty to act in good faith in settling claims and a breach of that duty will give rise to a cause of action by the insured." Pasipanki v. Morton, 61 Ohio App. 3d 184, 185, 572 N.E.2d 234 (1990) (quoting Bean v. Metro. Prop. & Liab. Ins. Co., 9th Dist. No. 13543, 1988 Ohio App. LEXIS 4275, 1988 WL 114464 at *1 (Oct. 26, 1988)). Gekko did not act in good faith to settle Vic’s claim against Donna, and their failure to do so enables Donna has a cause of action against Gekko.

There are many ways to save money on your car insurance policy. Some of them are obvious like paying for the entire policy rather than making payments or increasing you deductible on your collision coverage. However, the following are three often overlooked ways to pay less.

Going through the selected policies. Policies are legally binding. There are consequences in case a party fails to adhere to terms and conditions. Going through terms and conditions of selected covers will help you determine if it suits you or not. A person should go ahead and sign an insurance policy if the terms favor him.