Insurance coverage law deals with disputes between policyholders and insurance companies over benefits not paid after claims have been filed. Attorneys negotiate and litigate cases, reviewing policies and interpreting legal language to determine coverage and exclusions.
Insurance coverage law deals with coverage disputes that arise between policyholders and insurance companies. The subject of the conflict is any type of insurance policy that the policyholder pays with the expectation of receiving certain benefits. When such benefits are not paid by companies after claims have been filed, policyholders can initiate lawsuits or hire lawyers for advice on how to proceed. Some of the insurance policies that give rise to disputes include liability, health and omissions insurance. Insurance coverage law sometimes overlaps with other areas of law, such as intellectual property and employment law, and often includes contract law because insurance policies are written agreements.
Claims are first handled by the insurance adjuster. The adjuster determines whether claims are to be paid by the insurance company according to the policy. If the adjuster refuses to pay, they often forward it to the attorney who represents the company in insurance coverage disputes. The insured can then pursue the matter with an attorney practicing insurance coverage law with the hope of seeking a legal remedy in civil court.
Many attorneys who work in the field of insurance coverage law are litigators. They often try to negotiate with the other party, whether it’s the policyholder or the insurance company, to resolve the matter. If both parties fail to reach a resolution, the attorney represents his client in court, providing litigation defense to the insurance company or litigation representation to the litigation contractors initiating the lawsuit. Attorneys for both parties must review the insurance policy and prepare their case to argue that the insured’s rights should be protected in the plaintiff’s attorney case, or that the insurance company is not responsible for the coverage payments in the case of defense attorney insurance. Judges and lawyers use regional and national laws to interpret insurance contracts and determine their limits.
Insurance coverage law encompasses transaction based work in addition to litigation. Attorneys often review policies for clients before they sign deals or when they need to file claims. Lawyers often interpret the legal language in the settlement and explain the legal rights and principles that pertain to the settlement to their clients. The aim is to determine whether a present or future claim is covered by the policy and which exclusions apply.
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