Pennsylvania Insurance Legal Questions

If you believe that the policy should cover the rehab, you would proceed through whatever dispute resolution procedure is called for in your insurance policy (for example, it may require arbitration of any disputes).  If the policy doesn't set forth a method of dispute resolution, or you have exhausted all procedures called for by the policy, you would sue the insurance company for breach of contract.... Read More

It depends.  As with most legal questions, it is critical that all relevant facts be explored.  For this reason, you should consult with an attorney who could investigate all relevant facts and perform necessary legal research.  However, at least 2 issues are raised by your question.  Fraud is a misrepresentation of a material fact upon which you rely to your detriment. One issue relates to the fact that you may give someone authority to sign documents on your behalf.  Did you you knowingly gave the agent permission to affix your electronic signature?  If you did not give the agent such authority, then the contract (insurance policy) may be voidable. The other question is whether you were given a true and accurate description of the terms and conditions of the policy that was issued to you. You should consult with an attorney to obtain a full and accurate evaluation of the questions presented.... Read More

Medicaid may have a right to reimbursement for medical costs it paid to treat accident injuries.  So, if a medicaid reicipient is injured in an accident and requires medicaid to pay his/her treatment bills, then medicaid would have a lien against any recovery obtained by the injured party. To me, when you say that a "medicaid Defendant" won, that means that he/she succeeded and thus does not have to pay the plaintiff.  A defendant who wins, typically does not receive any payment and thus there would be nothing to be paid to medicaid.  Medicaid is to be reimbursed only if the medicaid recipient receives payment from the person causing the accident.... Read More

I'm sorry to hear about this.  Hang in there for a while longer.  It often takes a long time for insurance companies to investigate claims.   I'd wait a few more months before you decide to take the next step, but I'd follow up with them once every week or 2.  Try and cooperate as much as possible by providing the insurance company with anything they may need.   They may request your phone records, even bank statements.  This may seem a bit extreme, but it's fairly common with insurance investigations.  If you go another month or two and the claim is denied or the claim has not had any progress, you may want to discuss it with a lawyer.  However, you may want to wait until you get an official denial before you contact a lawyer, but do so fairly quickly after a denial letter is received to ensure you comply with time requirements.  Best of luck! NOTE:  This response is general in nature and should not be considered legal advice.  No attorney-client relationship exists or is formed by this response.  ... Read More

if you have coverage on your own policy, it is probably best to just go through your company and then your company will subrogate.  However, if not you probably need to find out what the insurance company leans by not being listed.  In some circumstances the suspended driver is an excluded driver and not covered for anything if he or she is driving a car on the policy.  however, in this case if the driver is operating the vehicle with the owners permission and not an 'excluded driver" then you may want to file a complaint with the Pa Insurance Commissioner, or if you are injured have an attorney address it. Scott Cooper scooper@schmidtkramer.com 717-888-8888... Read More

I think your answer would depend on the exact terms of the settlement/check.  Was there any kind of release included or langauge about what the money had to be spent on?  For example, did the letter or release say the money had to be sued to pay hospital bills and if not,  ___ would happen?  I would read the letter more carefully and see if there is any language like this in there.  If there was no such language then it is likely that the payment was not conditional (didn't have to be used to pay the hospital bills) and was maybe only to help with the bills.  If so, it is likely that nothing will happen except that your husband is still responsible for his outstanding medical bills.  If those are not paid it is possible that his wages could be garnished and/or that they will go into collections and could affect his credit score, etc. Best of luck! NOTE:  This response is general in nature and should not be considered legal advice.  No attorney-client relationship exists or is formed by this response. ... Read More

If you have your own insurance to cover this claim you should first proceed through your own carrier.  Then, if you do not I would suggest contacting an attorney who handles property damages claims.  Generally, a personal injury lawyer can do that.  He/she can review the claim and determine your rights. Scott Cooper scooper@schmidtkramer.com 717-888-8888... Read More

You can file suit without the assistance of an attorney.  However, I would recommend you get a free consultation with an attorney who can advise of the possibility of recovery regarding this issue. Even if you decided not to hire an attorney, they will likely provide you with information that would be beneficial to you.  Suits against insurance companies are pretty difficult and I would recommend trying to find an attorney to assist you, however, it is not required.  You can file pro se.  In addition, an attorney will help you understand any state specific laws and the statute of limitations.  You only have a certain time frame in which you can file suit before your claim will be forever barred and a local attorney can assist you with determining that.  In sum, you can do it yourself, but I would recommend seeking the assistance of a local attorney.  Best of luck! NOTE: This response is general in nature and should not be considered legal advice.  No attorney-client relationship exists or is formed by this information.  ... Read More

Your question does not indicate two things:  (1) was a claim made by you to the cleaning company and/or the insurance company, or (2) did either of them deny your claim and give specific reasons. I am not licensed in Pennsylvania, so you may need to check with someone there, but in general, you would need to make the claim against the cleaning company.  If they were at fault, the bond or insurance company would pay you.  HOWEVER, if there is only a general liability policy on the cleaning company, exclusions for damage caused by intentional acts, or for damage to property in the "care custody or control" of the insured may mean there is no coverage at all. A proper bond would make sure that if the cleaning company is responsible, that they will pay for it.  ... Read More