What is Insurance Law?
When and how claims can be filed and paidBy Super Lawyers staff | Reviewed by Canaan Suitt, J.D. | Last updated on February 3, 2023
Use these links to jump to different sections:
- Insurance Law – What You Need to Know
- An Overview of Insurance Law
- Common Questions
- Finding the Right Attorney for Your Needs
The insurance industry is wide-ranging and includes a variety of protective measures to afford peace of mind for you and your loved ones. Insurance law refers to the legal regulation around the business of insurance.
There are many types of insurance, all subject to their own rules and premiums. Conversely, there are also various types of federal statutes and state laws governing the regulation of insurance. In response to a U.S. Supreme Court decision that put insurance companies under the federal government’s regulation, Congress passed the McCarran-Ferguson Act of 1945, giving state insurance laws control over the insurance industry. So, control of the insurance industry varies by state regulation. Before you sign an insurance contract, you should know about the regulatory policies that encompass insurance law.
An insurance policy is a contract between you (the insured) and an insurance company. In your contract, you agree to pay the insurer a specified amount each month in exchange for the promise that they will protect you against financial loss (indemnity).
A lawyer can assist you as you enter into these contracts or when you’re seeking to enforce them. There are also scenarios wherein a third party will ask your insurance company to pay them for something you did, and a lawyer can defend you then, too.
Insurance Law – What You Need to Know
- This legal area is comprised of both state and federal law.
- There are two types of insurance: public and private.
- Public insurance programs are run by the government and include things like social security, Medicare, and Medicaid.
- Private insurance is the most common type and is run by private companies; it includes homeowners, car, health, life, and disability insurance.
- If you’re making an insurance claim against someone, you will want to seek the services of an insurance lawyer.
An Overview of Insurance Law
For individuals, insurance law concerns when and how claims can be filed and paid. If you’re making an insurance claim against someone, you might need an attorney. Likewise, if your insurance claim has been denied, you can get an insurance attorney to work on your appeal. If someone is making a claim against you, your insurance company will often assign an attorney to your case. However, some insurance companies allow the insured to select an attorney.
Types of Insurance
There are two types of insurance: public and private. Public insurance programs are run by the government and include social security, Medicare, and Medicaid. Private insurance is the most common type and is run by private companies. There are many things in which you can have an insurable interest and that can be covered by insurance, including homeowners, car, health, life, and disability insurance.
Homeowners insurance is designed to offer financial protection if your physical house or your personal belongings are destroyed by something like a fire. Your policy might not cover every natural disaster, so you may want to consider purchasing additional coverage. For example, flood insurance or earthquake insurance are common add-ons.
Most states require drivers to carry at least some auto insurance to protect other drivers from financial loss in the case of an accident. This type of insurance can offer financial protection if your car is damaged or stolen. Auto liability insurance can help you pay for others’ damages or injuries if you are involved in an accident.
Health care insurance is designed to help you cover the costs of general medical care and surgeries. This area of insurance is subject to a lot of change because of its public components; many areas of health insurance law are regulated by the government, which offers health insurance plans to qualifying individuals.
Unlike other types of insurance, life insurance offers financial protection to people other than the insured. When the insured party dies, these insurance plans provide support to third parties, often family members (beneficiaries). The insured party can select plans that range from termed support—usually 10 to 20 years—to permanent support.
Disability insurance will help supplement your income if you cannot work for a prolonged period due to illness or injury. Some employers offer either an employer-sponsored plan or a plan that employees can buy into. You can also purchase a plan through some professional organizations. If those options are not available to you or do not provide enough support, you can also consider purchasing a plan for a private insurer.
If your insurance provider has declined to cover your claim, you can often appeal the decision. Your policy will likely specify a time limit in which you must file your appeal, and you will want to make sure you understand why your claim was denied, as well as the proper procedure to appeal it.
In some jurisdictions, your appeal can be based on a claim of bad faith. Insurance companies owe their policyholders the duty of good faith and fair dealing, which means your insurer must deal with you fairly, honestly, and in good faith. However, sometimes insurance companies will try to avoid paying claims by acting in bad faith and misinterpreting their own policies so that you are not covered. If you believe this is why your claim was denied, you may want to consider speaking with an attorney.
Below are some common questions you might want to consider when meeting with an attorney for the first time.
- What do I do if my insurance claim is denied?
- Are my injuries covered through workers’ compensation benefits?
- Can I appeal if an insurer will not cover me?
- What kind of life insurance is best for my family?
- Do I need to have disability insurance before I am unable to work?
Finding the Right Attorney for Your Needs
It is crucial to approach the right type of attorney—someone with experience working at insurance law firms and can help you through your entire case. To do so, you can visit the Super Lawyers directory and use the search box to find a lawyer based on your legal issue or location.
To help you get started, you may want to consider looking for a lawyer practicing insurance law. If you need help with insurance plans or claims, you may want to consider a lawyer who specializes in insurance coverage. If you are defending against another person’s insurance claim, you should consider an insurance defense lawyer.
Should I Talk to a Lawyer?
State and federal regulations govern insurance law, so it can be complex. If you are trying to get your insurance company to pay, you will likely have to work within a system with strict deadlines and procedures. An experienced lawyer will have knowledge of the governing federal and state laws. These skilled practitioners can help you understand the framework and the strategies available to you. If you are defending against another party’s claim, your lawyer can obtain necessary documents or conduct depositions that can help your case.
A lawyer will further anticipate potential problems with your case and advise you on how to approach them. Your lawyer will also keep track of deadlines and file all the paperwork with the necessary courts and agencies, giving you one less thing to worry about.
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