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Accidental Death & Dismemberment (AD&D) Insurance

It seems simple. If an insurance company sells an accidental death insurance policy to someone, the insurance company should pay benefits if that person dies in an accident. But all too frequently, the insurance company comes up with reasons to avoid paying benefits.

The insurance company may concoct some way to blame the death on “sickness” so they can claim it was not the result of an accident. Or they may claim that a policy exclusion applies to this type of accident. Sometimes they claim there was some flaw in the paperwork when the insurance policy was purchased, and that it cannot be corrected now.

JuneLaw can help.

Auto Accidents & Michigan No-Fault Insurance

More than half of all brain injuries happen in auto accidents, and I’ve been litigating these my entire career, along with other auto-related injuries.

No-fault automobile insurance is mandatory for every motor vehicle registered in Michigan. If you are injured in an automobile accident, this no-fault insurance should cover all of your medical expenses resulting from your injuries for as long as you need care. But unfortunately it’s not always easy to receive the care you need.

For example, many no-fault insurance policies have “coordination” clauses that require you to turn to your health insurance first and your no-fault insurance second. In some cases, federal law may turn the tables and require your no-fault insurer to pay first.

If the situation is not addressed properly, it can result in serious delays in getting medical bills paid. In some circumstances, your health plan may demand that you repay them for these expenses.

If you hire us, we will also make sure you are receiving all your benefits. For example, people don’t know that auto insurance covers far more than medical bills. It covers home modifications or modified vehicles that are required because of your injury. It also covers people to take care of you that aren’t covered under typical medical insurance plans.

Michigan’s no-fault law got amended recently in such a way that even most lawyers can’t figure it out. Many experienced attorneys contact us to resolve disputes between the insurer and the employee. You can too.

Wrongful Death

Michigan’s wrongful death statute applies when a person dies in an auto accident that’s caused by someone else. The deceased individual’s estate sues and gets money and then the estate goes to the beneficiaries. These beneficiaries are determined in accordance with the wrongful death statute, and this is where the process can then run into many types of complications.

For example, life partners who are not married may be shut out under Michigan law. And there are also reimbursements that survivors are entitled to for pain and suffering. This could occur if somebody were hurt in a car crash and in the hospital in pain for a week before they died. And finally, if the deceased was supporting children, the survivor is entitled to additional compensation. You need somebody who’s good at finding applicable insurance coverage.

In some cases, you may need to start at the very beginning and prove that the other person caused the accident.

You need a lawyer that knows the ins and outs of Michigan’s wrongful death statute in order to maximize your benefits.

Liens

If your medical bills are being paid initially by your health coverage, they may have a lien or a right of recovery from your auto accident. If you don’t know how to deal with this, you could end up having to pay your medical bills out of pocket. This situation has to be handled by somebody who understands both health coverage law and no-fault law, and not very many lawyers do.

Contact JuneLaw to get the help you need.

Health Insurance

There is no doubt that health insurance is the most important benefit people get through their employers. We all know that it is critical to have coverage when a major health problem comes up. Nevertheless, too often, insurers deny health coverage just when it is needed most.

The insurance company may say that a particular treatment, surgery, or medical device is not medically necessary. Or they may say there is some exclusion in the policy that prevents you from getting the care you need. The person trying to heal is suddenly caught up in the red tape of preauthorization, out-of-network coverage, non-participating providers, discontinuation of coverage, and a host of other reasons for denying benefits. The “explanation” forms that fill your mailbox don’t explain much, but they do cause a great deal of worry.

Residential Care Coverage for Mental Health and Addiction Treatment

Residential care is often critical in order to fully recover from a mental health crisis, and is far more successful than hospitalization. Insurance companies are required to provide the same level of care for mental health and addiction recovery as they provide for physical treatment or other medical treatment.

But insurance companies often resist paying for residential care. Sometimes they will tell people that the problem is that Residential Care is “out of network,“ even if it turns out there is no available treatment “in network.” Or they may say the required treatment is not medically necessary – despite all of the treating doctors saying it is.

Families sometimes mortgage their houses to pay for their child’s mental health care. Don’t let this happen to you.

JuneLaw can help.

Social Security Disability Insurance

If you become totally disabled from work, you may need to apply for Social Security benefits. In fact, your long term disability insurer may require you to apply for Social Security Disability benefits.

Social Security is a right you have earned, and if you qualify, you should apply for your benefits. Many Social Security disability applications are denied initially, requiring people to go through a reconsideration process and possibly an appeal hearing with an administrative law judge. This is a complicated legal process.

Contact JuneLaw for help.

Life Insurance

Every life insurance company knows how important it is to pay benefits promptly after the death of an insured. Family members often need the benefits to maintain a home or take care of children. But when these survivors are at their most vulnerable, grieving the loss of a loved one, some insurance companies take advantage of them and deny benefits. And the reasons for the denial of benefits often seem to make no sense.

Sometimes the insurance company claims that the deceased person made a mistake filling out a form years ago, and the insurance company now labels this “misrepresentation or fraud.” In other cases, the insurance company says there was an exclusion in the fine print of the insurance policy that allows them to deny coverage. Sometimes the insurance company even sends a condolence letter one day and a denial letter the next. The family’s attempts to convince the insurance company to do the right thing go nowhere. The denial letters just add to the suffering of the grieving survivors.

Life Insurance Beneficiary Disputes

We also frequently encounter life insurance claims where there is a dispute over the proper beneficiary of a life insurance policy. This can happen in a number of situations. It is especially common when a divorced person dies without changing his or her life insurance beneficiary from a former spouse. Current family members are surprised to learn that the former spouse may reap an unintended windfall. It is essential in these cases to act quickly to protect your rights before the life insurance proceeds are distributed. It is common for lawyers to want to go to probate court to resolve beneficiary disputes, but most of the time they have to be done in federal court under ERISA, and that’s where I come into play.

Contact JuneLaw for help.

Long Term Disability (LTD) Insurance

Long term disability insurance can be critical when sickness or injuries prevent you from working. It enables you to continue to care for yourself and your family. It is reasonable to expect that you can rely on your long term disability insurance if you are medically unable to work. You have a right to the compensation you were promised. You should be able to focus on getting better and still be able to get by.

Sadly, insurance companies have a roster of doctors and investigators dedicated to certifying that you are not disabled. They may insist that their doctor examine you, but more commonly, the insurance doctor will simply review records without examining you at all. That doctor may declare that you can work, despite clear evidence of disability in your medical history. The insurance company may even claim to have video surveillance proving you can work, even if the video doesn’t show that at all. Or they might say they saw a picture of you smiling on social media, so you must not really be suffering or truly disabled.

If your insurer denies or discontinues your benefits, it is important to get help early in the process.

Contact JuneLaw for help.

Social Security Disability Insurance

If you become totally disabled from work, you may need to apply for Social Security benefits. In fact, your long term disability insurer may require you to apply for Social Security Disability benefits.

Social Security is a right you have earned, and if you qualify, you should apply for your benefits. Many Social Security disability applications are denied initially, requiring people to go through a reconsideration process and possibly an appeal hearing with an administrative law judge. This is a complicated legal process.

Contact JuneLaw for help.

Get Help From an
Experienced Lawyer

If an insurance company is denying your claim, you need help right away.

In our 25+ years of practice, we have become experts at getting our clients the benefits they deserve, but have been denied.

The sooner you call, the better we can help you.

Contact Us

Important note about your employee benefit claim
and ERISA

The Employee Retirement Income Security Act (ERISA) governs most of the benefits that people receive through their non-governmental employer, including many insurance policies. You may have seen ERISA mentioned in correspondence from your insurance company.

Insurers have taken advantage of obscure rules in ERISA that even most lawyers do not understand. If your benefit plan is governed by ERISA, you need to consult with a lawyer who is experienced in handling complex ERISA claims. Bob June is that lawyer.