Insurance Coverage Law
It is not unusual for insurance companies to attempt to avoid paying claims by denying coverage. For the average layman, an insurance policy is extremely difficult to read, much less understand. Insurance policies are specialized contracts which require analysis, under standard contract law, rules, regulations, cases and statutes unique to insurance products. With over 30 years of experience litigating insurance coverage issues, David and the staff at David J. Blevins, P.C. provide effective counsel to policyholders in a full range of insurance actions. Those actions include suits on the policy, declaratory judgment actions, interpleader actions, reservation of rights letters, bad faith claims, mediation, arbitration and removal to federal court. David has represented policyholders in claims or actions in several Georgia counties including Whitfield (Dalton), Murray (Chatsworth), Gordon (Calhoun), Catoosa (Ringgold), Walker (Lafayette) in addition to metro Atlanta and federal district court. The types of insurance policies we handle include:
- Automobile liability — Insult is added to injury when a person is sued for causing an automobile accident and their auto insurance carrier denies coverage or puts the policyholder on notice that the claim may exceed the policy limits. On the other hand, if one is the victim in an auto accident, it is extremely important to find all the automobile liability insurance available to pay for damages.
- Automobile Uninsured Motorist/Underinsured Motorist — Georgia has unique and complicated uninsured/underinsured motorist laws. Rarely if ever do insurance agents (or, for that matter, most attorneys) understand all the nuances in the statutes and cases. It is imperative to consult an attorney with knowledge of Georgia’s unique rules. David has written for the Georgia Bar Journal and taught other lawyers on the subject several times (see David’s professional qualifications).
- Homeowners — For most people, a home is their largest investment. When it is damaged by fire, wind, hail, storms, flooding, falling trees or other causes, it is critical that the homeowner’s casualty policy pays to restore the home.
- Commercial general liability (CGL) — Commercial general liability policies protect small businesses from claims and law suits. If coverage is denied or is inadequate, it is imperative for the policyholder to quickly assert his rights under the CGL and applicable riders. David has handled several such claims, including for some of the funeral homes sued in the North Georgia Crematory Cases.
- Health/major medical — Health insurance claims may be denied in a variety of ways. The insurance carrier may claim 1) the charges exceed ordinary, usual or customary charges; and 2) the medical bills arise from a non-covered event such as an automobile collision, preexisting condition or a host of other reasons.
- Life — It is difficult on a family when the tragedy of death is compounded by denial or delay in paying a claim on a life insurance policy. Like most states, Georgia has several laws which protect life insurance policy beneficiaries. Unfortunately, many families fail to seek legal representation. One of David’s first federal cases was a claim for life insurance benefits. Over the years, he has pursued such claims for surviving spouses, children and decedent’s estates in Dalton and several other North Georgia courts including the United States District Court for the Northern District of Georgia.
- Disability — Many people buy disability policies to protect them from the loss of income due to disability. Disability policies have a high rate of denial from insurance carriers. Most cases turn on either the definition of “disability” or the amount and source of an offset to benefits under the policy.
- Employee Income Retirement Security Act (ERISA) plans — Almost all health insurance and retirement plans that are paid by an employer are in part or in whole governed by a federal law called the Employee Income Retirement Security Act (ERISA), with a few exceptions such as for governments and churches. David has pursued ERISA claims against third party administrators (TPA), plan fiduciaries, and plan sponsors.