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Personal Injury Protection (PIP) covers against medical expenses and some of the losses that inevitably follow a traffic accident where drivers and their passengers are injured or killed. So, for example, you can claim loss of earnings and the equivalent of damages for pain and suffering. Where the driver dies, funeral expenses are also recoverable. Such policies are standard in the no-fault states. It’s expected claims will be settled without having to prove negligence, so you claim all your losses from your own insurer. Even in the at-fault states, holding a version of PIP, e.g. Auto Medical Payment cover, gives peace of mind, leaving it to the insurance company to sue in your name if the driver at-fault refuses to reimburse your insurer. Note that PIP cover is mandatory in 14 states, but the terms differ in their detail between those states. You should check through the small print before making a final decision on which policy to buy.

Such policies are supposed to make everyone’s life easier if they are injured, so it’s sad to see one insurer consistently refuse or reduce its customers’ legitimate claims. USAA is now facing its third class action law suit alleging a formal strategy to collect in the premiums and then refuse claims. In one sense, this is extraordinary given ASAA’s focus on the families of both serving and honorably retired members of our armed forces. A company that prides itself on looking after the interests of those defending our shores should offer top-class service. Instead, this latest law suit alleges the company is more interested in its bottom line, in effect cheating service personnel and their families.

The Plaintiff alleges USAA conspired with a second company, Auto Injury Solutions (AIS), to carry out a fraudulent cost containment program. Although the pleadings are quite general, it seems AIS produced dishonest reviews of medical claims which USAA then relied on in denying legitimate claims. What makes this particularly egregious is that this is the third law suit alleging a formal strategy not to pay out on medical claims. The first two suits were settled by USAA paying large sums in compensation. Under such circumstances, there’s a good case to be made for stripping USAA of its license to sell insurance. (more…)

The Brits sometimes have a quaint way of saying things but, when you understand what they mean, it make a lot of sense. They say, “Never buy a pig in a poke”. In the good old days of selling in markets, some farmers used to offer animals in a sack or poke. This was a sight-unseen sale. Buyers were supposed to trust the farmers to put healthy animals into the sack. Needless to say, only the unwise agreed to this strange offer. Moving back home, the insurance industry seems to think you should buy an insurance policy in a poke. A majority of policies are now sold through sites like this with quotes sent out automatically. If you want, you can buy the policy on the basis of the quote without ever seeing the policy. Many people only read their copy of the policy when the need for a claim arises. It came through the mail and sat in its envelope awaiting the day of need. Except, many then find their expectations dashed as it turns out may of the expected headings of damage have been excluded. This has come as very hard news to all those people who have recently suffered in Hurricanes Irene and Lee.

It should be automatic for insurers to give all those who are interested a clear sight of the policy before they buy. Indeed, there’s no reason in principle why all the standard policies and possible additional terms should not be posted online for all to see. When you go to almost all e-commerce sites, the terms of sale are posted on static pages. It’s somewhat depressing you actually have to push insurers into revealing their policies. Most will supply a copy if you ask nicely. Except, it doesn’t necessarily do you any good.

Attorneys are lovely people (at least their spouses no doubt think so) but their talent is to write in an obscure version of English no one without an advanced degree can understand. Now far be it from us to suggest insurers don’t want you to know what you’re buying, but it’s a common reaction among those who do try reading the policies. So, in Trenton, the Senate Majority Leader Barbara Buono has introduced a bill that would force all insurance companies to publish a buyers’ guide written in plain English. No more complicated grammar or long words. Every insurer would be required to get approval from the Insurance Commissioner that the information is supplied in a clear and unambiguous way. The longer term hope is these documents will defuse a lot of the confusion that interferes with the claims process. (more…)