“With insurance contracts… disputes are often about coverage”
Everyone should have insurance, and being insured does, in many ways, help us sleep at night. However, as with many contracts (and remember, an insurance policy is actually a contract), disputes sometimes arise. It is not unusual for there to be a dispute regarding the interpretation of insurance contract terms. And, with insurance contracts, those disputes are often about coverage. That is, the insurance company may claim that, even though you have insurance, your claim is not covered. This can be frustrating.
A short time ago, I attended a seminar on insurance coverage where recent Court of Appeals’ decisions served as reminders of some important issues to remember when faced with a coverage dispute.
First, Oregon law provides that if an insurance claim is not paid within six months of the filing of a proof of loss, the insured is entitled to a recovery of attorney’s fees if the dispute goes to court.
Second, many insurance policies include a “contract statute of limitations.” Ordinarily, a party to a contract has six years to bring a lawsuit. However, an insurance contract could provide for a much shorter statute of limitations; say, one year instead of six.
Finally, one must be careful that they are accurate when submitting a claim. Under certain circumstances, an insurance company has the right to cancel the insurance policy if the insured makes misrepresentations about the loss during the adjustment of the claim. In fact, accuracy matters in all insurance transactions; not only in submitting claims but in submitting applications and underwriting information as well. Coverage could be denied if information provided to the insurance company was not accurate, no matter when that information was provided.
In summary, treat any insurance claim as a contract dispute and pay careful attention to the details.
Steven W. Seymour is an accomplished business litigator with an emphasis on labor and employment law as well as fiduciary litigation. To contact Steve, or another attorney at Samuels Yoelin Kantor, call 503.226.2966, or by email at info@samuelslaw.com.
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