| Health Care Crimes |
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| Insureds have an obligation to be truthful when dealing with their insurers in relation to their claims under insurance policies. However, insureds sometimes attempt to submit fraudulent bills in order to recover under their health insurance policies. In response to such actions, federal legislation was passed to make certain acts related to health care claims illegal.
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| Tie-in Arrangements |
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| A "tie-in arrangement," also known as "insurance packing," in the insurance industry consists of a lender's extension of credit to a borrower on the condition that the borrower purchase certain insurance, usually from an insurer with close ties to the lender. The premium amounts for the insurance are usually added to the amount of the loan without the borrower's request or knowledge, and he may not find out about the tie-in arrangement until the lender presents the pre-prepared loan documents at the closing of the loan.More... |
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| Unfair Claims Settlement Practices Act |
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| When an insured or a beneficiary submits a claim to an insurer, the insurer has a duty to respond and to do so in a certain manner. The Unfair Claims Settlement Practices Act (UCSPA), a model act adopted in over 40 states, provides industry guidelines for the insurer to follow when paying or denying claims. In general, the UCSPA requires the insurer to act promptly and fairly in response to a claim with a reasonable basis for any denials.More... |
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| The CGL Policy Exclusion for Damage to the Insured's Property |
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| The standard comprehensive general liability policy insures a business against liability arising from personal injury or property damage suffered by a third party. Various exclusions are included in the CGL policy, including Exclusion J -- Damage to Property, that are designed to limit coverage to third party injury or damage. More... |
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| False Claims by Insured |
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| Various statutes prohibit the submission of false or fraudulent claims or evidence in connection with insurance claims. A person who commits such fraud may be subject either to civil liability to an insurer or to prosecution for a crime.
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