Insurance Claim – Car Insurance In Memphis http://carinsuranceinmemphis.net/ Fri, 24 Jun 2022 17:49:53 +0000 en-US hourly 1 https://wordpress.org/?v=5.9.3 https://carinsuranceinmemphis.net/wp-content/uploads/2021/06/icon-1.png Insurance Claim – Car Insurance In Memphis http://carinsuranceinmemphis.net/ 32 32 Ugh… We Didn’t Think About It – Cognitive Dissonance in Litigation | Denton https://carinsuranceinmemphis.net/ugh-we-didnt-think-about-it-cognitive-dissonance-in-litigation-denton/ Fri, 24 Jun 2022 17:49:53 +0000 https://carinsuranceinmemphis.net/ugh-we-didnt-think-about-it-cognitive-dissonance-in-litigation-denton/ Litigation is tough, complicated and always surprising. It can be very difficult for an organization to plan for the business problems that litigation brings. But no matter how many times you’ve dealt with litigation – explaining issues to a front-line supervisor who’s been named as a party, to board members, or others – some things […]]]>

Litigation is tough, complicated and always surprising. It can be very difficult for an organization to plan for the business problems that litigation brings. But no matter how many times you’ve dealt with litigation – explaining issues to a front-line supervisor who’s been named as a party, to board members, or others – some things seem to take the companies by surprise every time. These are all issues worth discussing with your manager, board, and other stakeholders to ensure you are prepared for some of the most shocking moments of cognitive dissonance we will encounter in litigation.

1. Truth is stable, but perception is fluid

Many people involved in litigation, whether as witnesses or parties, believe that once the truth is told, the issues will be resolved, because truth is, of course, a stable concept. However, what you discover during the litigation process is that the perception is completely fluid.

An employee may perceive your inquiry about how their child, mother, son or dog is doing as intrusive or inappropriate when you hear it exclusively as a simple “how are you?” While participants are still encouraged to tell the truth, we all see the truth slightly differently and it is the job of the complainant and their attorney to present the circumstances in a way that supports their case. This can be a particularly difficult concept when working on various issues with decision makers or perhaps the next step in the food chain, where you are justifying certain decisions that have been made. Objective truth is important and the more documentation you have to back up what happened and why, the better off you are as a defendant, but perceptual belief and emotion always come into play, especially in cases of labor law.

2. Strategy and your behavior are important

Litigation is not a game (unless you possibly think of gladiatorial pits), but the principles of gamification can apply. An analogy would be the video game Epic Mickey, a beautifully illustrated game produced by Disney in 2010. Epic Mickey has a “morality system” where the way you make alliances and how you behave – politeness and following the rules against destruction gameplay – changes the course of the game and alters your game options. While everything leads to the same basic results, how you behave can change how you get there. While total destruction may be compelling, sometimes cooperating with opposing counsel may be in the best interest of your litigation to achieve your desired outcome. The litigants who assist you throughout the process will take into consideration the venue, the court, the individual judge and the expectations of that judge or court. For example, you may hear a lawyer say, “The judge expects us to call the opposing lawyer before…”. it’s all part of the strategy to reach your end goal. Individual decisions matter in litigation. Whether this decision is made with your defense attorney regarding the production of documents or the granting of an extension or the decisions you make during an investigation or other process.

3. Disputes have many layers

Especially in the field of employment, there are many administrative and other layers that employers are not always prepared for. For an employee who has a grievance such as discrimination on the basis of race, age or disability, these should generally be filed with a local human rights commission, human rights commission state-based civilians or EEOC. It may end with the agency, or it may continue in state or federal court.

Each commission has its own independent rules, requirements and processes to navigate. The culture of that commission or administrative body, as well as the culture of the tribunal, can guide strategy in your approach to litigation. Cultivation varies from state to state and within different regions, including the EEOC. These are all issues that need to be considered, but when discussing these issues with someone who doesn’t have a lot of litigation experience, it can be complicated. Explain the multiple levels, how each level works, appeal processes, witnesses, experts, etc. It’s worth going through them step by step to make sure people are comfortable with the process.

4. Call your insurance company

Many employment law disputes are covered by Employment Practices Liability Insurance (EPLI), but many EPLI policies require early notification to the insurance company in order to fully utilize all coverage. Employers may not want to tell their insurance provider because they think the claim will be resolved quickly, at minimal cost, or the claim is simply unfounded and will go away. This is certainly a business risk that an employer could choose to take, but before making this decision you should carefully consider your policies, the nature of your coverage, any exceptions and whether or not you receive certain benefits as a result. early notification cases. . Don’t skip the insurance coverage assessment because you think a case is going to go away. Cases that you think will go away sometimes persist and can be quite expensive.

5. Allegations of retaliation do not require the original allegation of discrimination to have been valid

One of the things that may surprise people involved in litigation is that retaliation claims are self-contained. If someone has made an allegation that they have been discriminated against, even if that allegation is found to be invalid, the subsequent allegation of retaliation can still stand. If someone complains of discrimination and you demote or fire them later, especially near the complaint, it’s likely that a commission will assess this very carefully for a possible retaliatory claim. Retaliation is the most frequently filed claim in the United States because it relates to other claims. Whether you have a disability claim or a sex claim, you will likely have a retaliatory component as well. You should be careful and evaluate these issues with your defense attorney to ensure that you are making decisions that best support the defense of all claims.

6. Discovery can be broad, intrusive and brutal

The opposing attorney usually asks for a lot of information and the request doesn’t always make sense or maybe you don’t think it applies to the case at hand. It is a long, expensive and sometimes very difficult process. While there are ways to limit certain types of discovery requests that are excessive or, in some cases, downright ridiculous, this is also a process that should be managed through litigation.

If lawyers cannot agree on what should and should not be produced, it requires court intervention. The court then assesses which documents are or are not required and in many cases the courts err on the side of over-inclusion in order to avoid either party claiming that they have been denied documents. relevant information.

Of great importance, long before you see a dispute, are your document retention policies, how files and data are stored, whether they are secure or not, whether they are accessible and stable or no and the fact that you have put a dispute hold in place. In other words, once you knew there might be a claim, you didn’t destroy anything. These are all critical factors that will help manage discovery.

7. Disputes take a long time

It doesn’t matter if the truth seems obvious. It doesn’t matter if the claim has no merit or if your attorney was quick and did everything they’re supposed to. Litigation is a bit like playing tennis. One side kicks the ball over the net, then you have to wait for the other side to send it back before the process can continue. Sometimes you have to wait for the referee to make a call. It’s very difficult to force the plaintiff to make a claim, to engage in mediation, or to do any of the kinds of things that might help bring about a resolution early in a dispute. While an employer’s defense attorney can compel discovery responses and other things, there are things they simply cannot do in litigation. Even if all deadlines are met, disputes can take a long time to go through the process and your counsel or others who are part of the litigation planning process should be aware of any deadlines that are likely to apply.

8. Transfer of fees

Many labor law cases settle, at least in part, because of fee transfer issues. In the United States, if you are defending certain employment law claims such as race, age, or sexual harassment, and the other side wins the lawsuit, the laws allow costs to be shifted. In other words, if they receive even small sums, the plaintiff’s lawyer can demand fees and the defense must pay them. Plaintiff’s counsel certainly take this into account when making claims in litigation and when making demands to settle any form of litigation. Insurance companies also take this into account. Your planning group should therefore be aware of the potential issue of fee shifting in order to plan appropriately.

Conclusion

While the issues discussed above sometimes seem the same as those faced by every other business, each dispute is unique. But there are consistent scenarios you need to plan for well before a dispute occurs, including:

  • Documentation retention policies and storage plans
  • Training for supervisors
  • Checks and balances with respect to discipline and dismissal

Having these steps in place helps you achieve or demonstrate this objective truth in litigation. Although a lot of litigation seems counterintuitive, being prepared helps you resolve these types of issues.

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Prince George sues insurance company over COVID-19 revenue loss https://carinsuranceinmemphis.net/prince-george-sues-insurance-company-over-covid-19-revenue-loss/ Thu, 23 Jun 2022 00:28:38 +0000 https://carinsuranceinmemphis.net/prince-george-sues-insurance-company-over-covid-19-revenue-loss/ Breadcrumb Links Local News The City of Prince George is suing its insurer because the company denied a claim for lost revenue related to COVID-19. The City of Prince George says it paid ‘significant’ premiums to Royal and Sun Alliance Insurance Canada, one of Canada’s largest property and casualty insurance companies, to obtain protection under […]]]>

The City of Prince George is suing its insurer because the company denied a claim for lost revenue related to COVID-19.

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The City of Prince George is suing its insurer for damages after the company denied the city’s request for business interruption coverage during the COVID pandemic.

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The city says that after the issuance of provincial health orders aimed at preventing the spread of the virus in March 2020, it was forced to close its civic facilities, including the CN Centre, Rolling Mix Concrete Arena, Elksentre Arena and Kin Center arenas.

The swimming pools and the Prince George Conference and Civic Center were also temporarily closed.

“Prince George has suffered a significant loss of revenue from the closure and limited operations of civic facilities,” the lawsuit filed in the Supreme Court of British Columbia said. No dollar figure for the losses was provided in the lawsuit and the city declined to comment because the matter is before the courts.

The temporary closure of Treasure Cove Casino, the operation of which provides Prince George with a percentage of net gaming revenue, has also had a negative impact on the city, according to the lawsuit.

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City says it paid ‘significant’ premiums to Royal and Sun Alliance Insurance Canada (RSA), one of Canada’s largest property and casualty insurance companies, to obtain protection under its business interruption coverage .

Prince George claims that in August 2020 RSA refused to cover the losses.

He alleges that the RSA is contractually bound to the general civil authority cover of the policy to cover all or part of Prince George’s losses, with the policy also providing cover for losses resulting from business interruption caused by damage caused by an insured risk.

“Viruses are assured perils,” the lawsuit states. “Insured perils include known and unknown perils, including substances such as viral agents that render areas unusable. There is no specific exclusion in the policy for the peril or risk of viral pathogens, contagious diseases or pandemic.

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The lawsuit notes that the RSA denied the claim for several reasons, including that there had been no physical loss or damage to the insured property to trigger the business interruption cover.

But the suit went on to say that RSA failed to consider the denial of coverage provisions and did not deny coverage based on exclusion clauses.

The City seeks general damages, damages for breach of contract and special damages.

No response has been filed in the lawsuit, which contains allegations that have not been tested in court. RSA could not be reached.

A spokesperson for the Union of British Columbia Municipalities said he had not heard of any other similar lawsuits filed by municipalities in the province.

The Municipal Insurance Association of BC, which provides insurance to 90% of local governments in British Columbia but not to a number of its major cities, including Vancouver and Surrey, could not be reached.

The Insurance Bureau of Canada, the national industry association representing Canada’s private home, auto and business insurers, declined to comment because of the litigation.

RSA has been named as a defendant in several other lawsuits, including claims made by the Edmonton Oilers and its associated companies for $174 million in alleged COVID-related business losses and the Calgary Flames for $125 million in losses. allegedly related to the pandemic, according to the news.

kfraser@postmedia.com

twitter.com/keithrfraser

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Mississippi Supreme Court counts unproven benefits in malpractice claim https://carinsuranceinmemphis.net/mississippi-supreme-court-counts-unproven-benefits-in-malpractice-claim/ Tue, 21 Jun 2022 05:04:11 +0000 https://carinsuranceinmemphis.net/mississippi-supreme-court-counts-unproven-benefits-in-malpractice-claim/ New You can now listen to Insurance Journal articles! The question for the Mississippi Supreme Court was whether the amount of damages owed to an injured employee for her attorney’s negligence should include the workers’ compensation benefits she missed. The answer, the court decided last week, is “yes”, although the extent and duration of the […]]]>
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The question for the Mississippi Supreme Court was whether the amount of damages owed to an injured employee for her attorney’s negligence should include the workers’ compensation benefits she missed.

The answer, the court decided last week, is “yes”, although the extent and duration of the injury has never been judged.

“Upon review, we find that the Court of Appeals failed to understand the impact of the law firm’s negligence on Chandler’s ability not only to testify, but also to prove her workers’ compensation claim,” wrote Judge James Maxwell for the majority in Turner & Associates v Lori Chandler. “When this practical reality is taken into account, we find that the trial court’s decision is sufficiently supported by the evidence and should stand.”

The case involved the law firm Bennie Turner, in West Point, Mississippi. In addition to being a lawyer, Turner was a well-known television broadcaster and one of the only African-American state senators in the state legislature. He served in the chamber for 20 years until his death in 2012.

Late Senator Bennie Turner (Facebook)

The Chandler case began in March 2008, when Chandler worked at Cooper Tire Co. in northern Mississippi. She was driving a forklift when another forklift collided with her, sending Chandler to the emergency room the next day. The court opinion did not state the extent or nature of her injuries, but said they were sufficient for her doctor to place her under sedentary work restrictions.

Cooper fired the woman three days later, saying the company didn’t need help with secretarial work, the court’s opinion explained.

Chandler started physical therapy, but ended it after two months when she found out she was pregnant. In August of that year, she decided she needed legal representation and contacted the Turner firm. She testified that she met Turner’s daughter, attorney Angela Lairy, although Lairy later denied meeting the injured worker.

For reasons not explained in the court’s notice, the company did not file Chandler’s workers’ compensation claim within the two-year statute of limitations, dooming any chance of recovery. benefits, the Supreme Court noted. Seeing no action on her case, Chandler in 2011 contacted Turner’s other daughter, a case manager at the firm named Carolyn Karriem.

Instead of telling Chandler of the mistake of not filing the claim, Karriem falsely told Chandler that the company was negotiating a settlement with Cooper Tire.

“Not only was that false, Karriem actually forwarded a bogus $25,000 settlement offer,” Judge Maxwell wrote in the notice. Chandler rejected the “offer”, and over the next year Karriem continued to concoct false claims about settlement offers of increasing amounts. Around this time, Turner died and Lairy resumed practice, the court heard.

Shortly after, Karriem said Cooper Tire had agreed to a $100,000 settlement. She sent Chandler a bogus settlement agreement, which she signed.

After six months without a check in the mail, Chandler started asking questions. She soon discovered that there was no offer to settle and no claims had been filed. She hired a new law firm and sued the Turner firm, along with Lairy and Karriem, for malpractice.

The trial court judge awarded Chandler $50,000 in compensatory damages, based on her attorney’s calculation that she had been out of work for two years and should have been paid two-thirds of her salary for temporary total disability. The judge also awarded Karriem $100,000 in punitive damages.

Justices of the Supreme Court of Mississippi. Maxwell is in the front row, second from the right. (Ms. Judicial)

On appeal, the Mississippi Court of Appeals denied compensatory damages, noting that Chandler had failed to support his injury claims with substantial medical evidence.

The high court found the appeals court erred and reinstated the $50,000 compensatory damages, reducing the total amount in the case to $150,000.

“If this were a workers’ compensation case, we might agree with the Court of Appeals,” Judge Maxwell wrote. “But this is not a workers’ compensation case. This is a case of legal malpractice. And it was at least partly due to the law firm’s negligence – which is undisputed – that Chandler was unable to obtain the medical evidence required to be compensated by the Workers’ Compensation Board, if his application had been properly filed.

The high court noted that Chandler explained that after the birth of her child in late 2008, she was unable to follow treatment for her forklift injury. Her doctor also gave her “the sleight of hand,” urging her to go through a workers’ compensation attorney to finalize the claim, she testified.

“In other words, because of the uncontested negligence of Turner & Associates, Chandler lost not only the ability to file a workers’ compensation claim, but also the ability to prove his workers’ compensation claim. labor by sufficient medical evidence,” the Supreme Court said.

The court sent a question back to the trial court — whether Lairy, now Angela Turner Ford, is jointly liable for compensatory damages of $50,000.

Associate Judge Josiah Coleman dissented in the opinion, arguing that Chandler never proved his compensation claim had any merit.

Lawyers handling the case could not be reached for comment on Monday.

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Mississippi Medical Malpractice

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IRDAI plans to link insurance fraud to individuals’ credit score https://carinsuranceinmemphis.net/irdai-plans-to-link-insurance-fraud-to-individuals-credit-score/ Sun, 19 Jun 2022 13:49:00 +0000 https://carinsuranceinmemphis.net/irdai-plans-to-link-insurance-fraud-to-individuals-credit-score/ Illustration: Binay Sinha Business Standard has always endeavored to provide up-to-date information and commentary on developments that matter to you and that have wider political and economic implications for the country and the world. Your constant encouragement and feedback on how to improve our offering has only strengthened our resolve and commitment to these ideals. […]]]>

Illustration: Binay Sinha

Business Standard has always endeavored to provide up-to-date information and commentary on developments that matter to you and that have wider political and economic implications for the country and the world. Your constant encouragement and feedback on how to improve our offering has only strengthened our resolve and commitment to these ideals. Even in these challenging times stemming from Covid-19, we remain committed to keeping you informed and updated with credible news, authoritative opinions and incisive commentary on relevant topical issues.

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First published: Sunday, June 19, 2022. 7:14 PM IST

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Firm Faces Skeptical 9th ​​Circ. In ‘El Chapo’ Insurance Litigation https://carinsuranceinmemphis.net/firm-faces-skeptical-9th-circ-in-el-chapo-insurance-litigation/ Fri, 17 Jun 2022 21:49:00 +0000 https://carinsuranceinmemphis.net/firm-faces-skeptical-9th-circ-in-el-chapo-insurance-litigation/ By Dorothy Atkins (June 17, 2022, 5:49 p.m. EDT) — A private equity firm faced a skeptical Ninth Circuit panel on Friday trying to rekindle claims that its insurer must cover the underlying litigation over a facility she sold that was overrun by El Chapo’s drug cartel, with two judges saying the company appears to […]]]>
By Dorothy Atkins (June 17, 2022, 5:49 p.m. EDT) — A private equity firm faced a skeptical Ninth Circuit panel on Friday trying to rekindle claims that its insurer must cover the underlying litigation over a facility she sold that was overrun by El Chapo’s drug cartel, with two judges saying the company appears to contradict arguments she’s previously made.

The insurance dispute has its roots in a $15 million fraudulent concealment lawsuit that Mexican real estate developer FINSA filed against private equity firm AKN Holdings, known as OpenGate Capital LLC, after realizing that AKN had sold a Mexican manufacturing plant to FINSA in 2014 without disclosing it. the drug cartel led…

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Lakers ask court not to return virus coverage claim https://carinsuranceinmemphis.net/lakers-ask-court-not-to-return-virus-coverage-claim/ Wed, 15 Jun 2022 21:19:00 +0000 https://carinsuranceinmemphis.net/lakers-ask-court-not-to-return-virus-coverage-claim/ By Riley Murdock (June 15, 2022, 5:19 p.m. EDT) – The Los Angeles Lakers have rebuffed efforts by a Chubb unit to get a California federal court to change its mind on the only insurance claim related to the Team COVID-19. let’s move on, arguing that a recent ruling doesn’t change the facts of the […]]]>
By Riley Murdock (June 15, 2022, 5:19 p.m. EDT) – The Los Angeles Lakers have rebuffed efforts by a Chubb unit to get a California federal court to change its mind on the only insurance claim related to the Team COVID-19. let’s move on, arguing that a recent ruling doesn’t change the facts of the case.

The team challenged Federal Insurance Co.’s arguments that an April state appeals court ruling changed California law enough to overturn the district court’s ruling, arguing in a brief released Tuesday that the new ruling only concluded that the virus alone does not cause physical loss. or damage.

The Lakers have already established facts that satisfy…

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Plaintiffs claim victory after lawsuit dropped to block SB 76 ban on rooftop solicitations https://carinsuranceinmemphis.net/plaintiffs-claim-victory-after-lawsuit-dropped-to-block-sb-76-ban-on-rooftop-solicitations/ Tue, 14 Jun 2022 05:03:56 +0000 https://carinsuranceinmemphis.net/plaintiffs-claim-victory-after-lawsuit-dropped-to-block-sb-76-ban-on-rooftop-solicitations/ New You can now listen to Insurance Journal articles! When the Florida Legislature approved Senate Bill 76 last year, with its restrictions on roofing contractors soliciting homeowners, insurers saw it as a blow against fraudulent and exaggerated roof claims. Then a contractor, Gale Force Roofing and Restoration, and others quickly filed suit against the state […]]]>

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When the Florida Legislature approved Senate Bill 76 last year, with its restrictions on roofing contractors soliciting homeowners, insurers saw it as a blow against fraudulent and exaggerated roof claims.

Then a contractor, Gale Force Roofing and Restoration, and others quickly filed suit against the state law enforcement agency. In July 2021, a federal judge issued an injunction, temporarily suspending the law’s solicitation provisions, noting that bans may violate roofers’ constitutional right to free speech. The lawsuit drew protests from the insurance industry, but eventually led to the passage of other far-reaching but more nuanced laws at Florida’s special session last month.

Now, both sides in the Gale Force lawsuit have agreed that, thanks to recent measures enacted into law, the SB 76 restrictions are moot. The same federal judge who suspended the 2021 law agreed on Friday to dismiss the complaint.

“SB 2D now has the force of law and has resolved the complaints that Plaintiffs and Plaintiffs’ Intervenors have raised,” reads the joint motion to dismiss the case, filed in U.S. District Court for the Northern District of Florida. “In sum, the declaratory and injunctive relief sought in the complaints is now ‘inappropriate’ and the matter moot.”

Gale Force Roofing’s attorney said Monday that his client essentially prevailed in the lawsuit, prevented the strict bans from taking effect and forced the Legislature to revise the law.

“Gale Force won its lawsuit, and it was only dismissed because there was no other remedy (other than the attorneys’ fees at issue) that the court could award,” the author wrote. attorney Jeremy Bailie, of St. Petersburg, in an email.

Senate Bill 2D, one of two reform bills approved in the special session on insurance May 23-25, made a wide range of legislative changes designed to limit roofing claims, unnecessary litigation and plaintiffs’ attorney fees. It also amended the same section of state law that last year’s SB 76 dealt with the solicitation of roofing work.

SB 76 had prohibited any “written or electronic communication by a contractor that encourages, instructs or induces a consumer to contact a contractor or public adjuster for the purpose of making an insurance claim for roof damage.” This included flyers, door hangers, business cards and emails.

This year’s SB 2D only prohibits advertisements that lack a disclaimer clearly stating that the owner is responsible for paying the insurance deductible and that a contractor offering to waive or pay the deductible is guilty of a third degree felony.

Florida Rep. Jay Trumbull, right, SB 2D House sponsor, and Rep. Matt Willhite during the passage of the bill in the special session. (AP Photo/Phil Sears)

The only question remaining in the Gale Force lawsuit is how much attorneys’ fees accrued in the case – and who will pay them. Parties have until July 13 to file motions for costs and expenses, Judge Mark Walker wrote in his June 10 order.

The motion to dismiss also brought up a point that is sure to make the state capitol laugh. The motion notes that the case is ripe for dismissal because the new law repeals the provisions of SB 76, those provisions are unlikely to be re-enacted, and SB 2D was not passed simply to manipulate court thinking.

“First, the legislative changes were the product of thoughtful deliberation by the Florida Legislature, which met in special session to pass comprehensive reforms to the state’s insurance laws,” reads the statement. motion.

Those present at the special session can agree that while lawmakers gave a number of speeches about the pros and cons of SB 2D, they did not engage in real deliberation: passing the bill and of its counterpart, SB 4D, seemed like an early conclusion before the session started. The bills were reportedly crafted by the governor’s office and House and Senate leaders, and barely a word was changed during the session. Some 27 amendments were proposed, including a freeze on home insurance rates, but none passed.

SB 2D also added other provisions that were not mentioned in the motion to dismiss SB 76 lawsuit. A major change now prohibits benefit assignees from being awarded their attorneys’ fees, even if prevail in prosecution. Insurance industry advocates said it could help reduce the solicitation of roofers and should significantly reduce the thousands of AOB lawsuits filed each month in Florida.

It remains to be seen whether Gale Force Roofing will now join a lawsuit filed just days after the special session, which challenges the constitutionality of SB 2D. Bailie said he was not aware of any intervention plans from his client.

The lawsuit was filed in Leon County Circuit Court by the Restoration Association of Florida, a group of contractors, and Air Quality Assessors, a company that tests homes for mold after water leaks. .

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Consumer court orders insurance company to pay ₹40,000 to patient https://carinsuranceinmemphis.net/consumer-court-orders-insurance-company-to-pay-%e2%82%b940000-to-patient/ Sun, 12 Jun 2022 03:14:10 +0000 https://carinsuranceinmemphis.net/consumer-court-orders-insurance-company-to-pay-%e2%82%b940000-to-patient/ A consumer court in Ludhiana, Punjab has ordered an insurance company to settle the medical claim of ₹40,000 after finding that the company was only partially covering the plaintiff’s medical bill. According to a report by Hindustan Times, patient Manjit Singh Chahal had undergone surgery at Columbia Asia Hospital, Patiala in 2018. The cost of […]]]>

A consumer court in Ludhiana, Punjab has ordered an insurance company to settle the medical claim of 40,000 after finding that the company was only partially covering the plaintiff’s medical bill.

According to a report by Hindustan Times, patient Manjit Singh Chahal had undergone surgery at Columbia Asia Hospital, Patiala in 2018. The cost of his surgery was 1,28,546 of which the insurer paid 85,918 and Chahal had to pay around 42,000 out of pocket.

Chahal had asked the District Consumer Dispute Redress Commission to settle his claim and pay him compensation for 1,50,000.

The insurance company argued that the complaint was premature and that Chahal had not approached Park Mediclaim Insurance for settlement of his claim or filed the receipt for payment made.

According to the daily, the insurance company specifies: “The complainant should have lodged a complaint with the firm if the claim had been denied. Upon receipt of a request for cashless payment on September 10, 2018, authorization to pay the hospital until 40,000 was granted by letter dated September 12, 2018. After the final invoice of 1,28,546 has been received, 85,918 were sanctioned. However, due to an unintentional error, the total amount sanctioned 1 25 918 could not be communicated to the hospital, for which reason it invoiced the difference to the plaintiff”.

However, the Consumer Court said: “The argument that the plaintiff should have filed a regular claim does not appear to be tenable as it is admitted by the insurer that he intended to pay the final invoice up to 1,25,918 which was to be paid directly to the hospital”.

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Atain seeks to escape $2.8 million home improvement claims https://carinsuranceinmemphis.net/atain-seeks-to-escape-2-8-million-home-improvement-claims/ Fri, 10 Jun 2022 21:43:00 +0000 https://carinsuranceinmemphis.net/atain-seeks-to-escape-2-8-million-home-improvement-claims/ By Ganesh Setty (June 10, 2022, 5:43 p.m. EDT) – Atain Specialty Insurance has told a California federal court that it should not have a duty to defend or indemnify two contractors facing a lawsuit seeking approximately $2.8 million in damages for claims of construction defects and delays in a San Diego home remodel. The […]]]>
By Ganesh Setty (June 10, 2022, 5:43 p.m. EDT) – Atain Specialty Insurance has told a California federal court that it should not have a duty to defend or indemnify two contractors facing a lawsuit seeking approximately $2.8 million in damages for claims of construction defects and delays in a San Diego home remodel.

The insurer said in its complaint Thursday that the underlying claims Jose Figueroa and Kenneth Hawkins filed against Welter Electric and Solar Inc. and Marrokal Design & Remodeling LLC are not property damage covered by Welter’s policies with Atain. Specialty Insurance Co.

According to the lawsuit, Figueroa and Hawkins contracted with Dream Design Builders in August 2017 to…

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Nice Deer Raises $1M in Pre-Seed Funding from DisrupTech https://carinsuranceinmemphis.net/nice-deer-raises-1m-in-pre-seed-funding-from-disruptech/ Tue, 07 Jun 2022 05:32:48 +0000 https://carinsuranceinmemphis.net/nice-deer-raises-1m-in-pre-seed-funding-from-disruptech/ Egypt – Nice Deer, an insurtech startup offering innovative health insurance solutions to the Egyptian market, raised $1 million in a pre-seed funding round led by DisrupTech Ventures. Established in early 2022 and currently operating in Egypt, Nice Deer aims to bridge the gap between healthcare providers, health insurance companies and health insurance beneficiaries by […]]]>

Egypt – Nice Deer, an insurtech startup offering innovative health insurance solutions to the Egyptian market, raised $1 million in a pre-seed funding round led by DisrupTech Ventures.

Established in early 2022 and currently operating in Egypt, Nice Deer aims to bridge the gap between healthcare providers, health insurance companies and health insurance beneficiaries by facilitating insurance and claims reimbursement , Nice Deer was born out of IT Fusion’s 10-year leading status as a technology provider for the top Third Party Administrator (TPA) in Egypt.

Nice Deer uses a one-stop-shop platform to connect healthcare providers with multiple health insurance companies and TPAs, as well as facilitate communication between patients and doctors. The Nice Deer platform also facilitates effortless and instant medical claims approval and efficient claims submission between healthcare providers, insurance companies, TPAs ​​and beneficiaries.

With comprehensive medical data, data-driven assessments, and the use of AI technology, Nice Deer prevents health insurance abuse and is early in detecting fraud attempts. Also, it recommends medications based on patients’ medical history, alerting doctors to any drug or drug interactions.

“In Egypt, out-of-pocket expenditure as a share of current health expenditure for Egypt was 62.7%,” says Mostafa Medhat, CEO of Nice Deer.

“Nice Deer aims to help the insurance industry in Egypt to develop smoothly and close this protection gap, since in similar countries this percentage is much lower and than with the insurance law expected, such a high percentage could go much lower.”

Malek Sultan, co-founder of Disruptech, said: “We are very proud of Disrupttech’s investment with the Nice Deer founding team, we believe Nice Deer will be in an excellent position to support the government’s plans to increase the number of beneficiaries of private health insurance in Egypt, Nice Deer will use the extensive network of healthcare providers and insurance brokers of TPAs ​​to penetrate untouched areas, especially small and medium-sized enterprises (SMEs).

With insurance products such as Health Savings Accounts, Nice Deer will be the first to offer SMB health insurance coverage, allowing SMB employees to claim their insurance for various medical and general wellness services. , including prescriptions, dental, eye care, gym memberships, etc. .

© 2022 Daily News Egypt. Provided by SyndiGate Media Inc. (Syndigate.info).

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