Author: Mark Wolfe

When you purchase a homeowners insurance policy, you make a substantial financial commitment to your insurer. In return, you expect it to hold up its end of the bargain and provide coverage for certain types of damage to your home. Sadly, homeowners insurance companies often act against their policyholders’ interests. Here are just a few recent examples: Hurricane Katrina In the wake of Hurricane Katrina, thousands of policyholders’ claims were denied on the premise that their homes were exclusively damaged by water. Since flood damage isn’t covered by many policies, this was enough to ruin many hardworking homeowners. In cases that clearly involved wind damage, insurers went even further and argued that standard homeowners policies were insufficient to cover “dual damages.” Many residents successfully sued to have these decisions reversed. Hurricane Sandy While standard homeowners insurance policies don’t cover flood damage, homeowners who had supplemental flood insurance policies were sure that they’d be covered after Hurricane Sandy. Unfortunately, tens of thousands of claims in New York and New Jersey were denied on the basis that flood-related damage was caused by groundwater rather than surface floods. Many policyholders who sought advice from licensed attorneys in the wake of the storm were able to challenge these questionable denials of coverage. Northridge Earthquake In some cases, insurers resort to outright fraud. After a major earthquake in the Los Angeles area, some policy issuers simply forged homeowners’ signatures on coverage waivers to avoid paying claims. Needless to say, this was not an acceptable maneuver. Many homeowners who enlisted the help of trained legal professionals were able to mount successful court challenges to their insurers’ underhanded tactics. “Mundane” Denials In all of the situations that we described above, insurance companies were motivated by the threat of heavy financial losses to disregard their policyholders and deny legitimate claims. Unfortunately, the same principles apply to individual claims. Since burst pipes, tree damage and other “mundane” issues don’t make headlines, insurance companies might actually be more inclined to deny individual homeowners’ claims on such matters. Homeowners insurance companies deny all manner of claims, but the most commonly ignored include water damage and structural problems like roof deterioration or “settling.” For water-related claims, insurance companies often attempt to argue that the source of a damaging inundation is external and thus isn’t covered by traditional homeowner’s insurance. For structural problems caused by storms or faulty construction, insurers may point to the policy’s vaguely defined “wear and tear” clause. If you’re fed up with homeowner’s insurance companies that don’t respect their policyholders, you need an experienced attorney who knows the insurance business through and through. Learn more about your options at our website or call us at 866-975-7766.

If you become unable to work due to a mental or physical health condition, you may be entitled to file a disability claim online or at your nearest Social Security Administration office. There’s a tremendous amount of publicly available literature about the filing process, but ensuring that your honest disability claim is accepted might not be as easy as it sounds. We’ll discuss why some honest claims are denied and offer some friendly advice about fighting for your right to disability insurance. What Are the Basic Criteria for a Legitimate Disability Claim? While claims for disability insurance are always evaluated on a case-by-case basis, there are a few key criteria that applicants are expected to meet. These usually include: •    An inability to perform Substantial Gainful Activity (SGA) or earn more than $1,040 per month at a regular job •    A qualifying medical condition that prevents reasonable work activity •    Doctor-prescribed restrictions on physical activity, including limitations on standing, lifting or walking •    An inability to fulfill the duties of the applicant’s most recent job Why Some Claims Are Denied Honest disability claims can be denied for a variety of reasons. In far too many cases, applicants simply aren’t aware that they have to file specific pieces of paperwork or meet specified deadlines. In others, they change residences and can’t be reached by Social Security Administration employees. Other common reasons include: •    Past criminal convictions •    Missing or incomplete records •    Misunderstandings that result in a failure to meet therapy guidelines •    A disability that’s determined to be temporary If your disability claim has been denied for any of these reasons, a trained legal professional can help you navigate the treacherous waters of the appeals process. How to Appeal Appealing a denied disability claim is much easier with proper representation. You’ll need to inform the proper authorities of your desire to appeal within 60 days of receiving your denial. Additionally, you’ll need to attend a special hearing and speak directly with a judge. If your initial appeal is denied, you can lodge another appeal with the state’s Appeals Council or take the matter to federal court. Success Rates and the Benefits of Professional Representation In Alabama, just 30% of initial disability claims are approved. Upon appeal, approval rates roughly double. This underscores the importance of hiring a legal professional to guide you through the claims and appeals processes. Our team of disability insurance specialists knows the ins and outs of Alabama’s confusing legal framework and is proud to fight for their clients’ rights. For more information about contesting a denied disability claim or any of the other services that our Mobile, AL law firm offers, visit our homepage or call 866-975-7766.