I want to know if I can bring a lawsuit against a private insurance company

UPDATED: Sep 30, 2022

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I want to know if I can bring a lawsuit against a private insurance company

I was involved in an 18 wheeler accident and have been on benefits from a private insurance company since. I have recently had surgery and am starting therapy. The insurance company has in formed me that my benefits are fixing to expire. I am in no way ready to go back to work and still have issues they didn’t address.

Asked on June 19, 2017 under Insurance Law, Texas


SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 5 years ago | Contributor

What are you suing them for? An insurance policy is a contract: an insurer needs to pay you those amounts or benefits--and ONLY those amounts or benefits--called for in the policy/contract. So if they are violating the terms of the contract/policy, in that you are owed more or longer-duration benefits under it, then if they cut them off prematurely, you could sue them based on breach of contract to get the benefits you should recieve.
But if under the policy's terms, your benefits are expiring--they have paid out for as many visits, or as much money, or for as long a period of time, as they are required--then they can cut off your benefits once they exceed what you are entitled to under the policy. They do not need to pay even $1 more or for even one more doctor/therapist/clinic visit that the policy requires, and your need for more benefits doesn't matter: all that matter is what the policy says.

IMPORTANT NOTICE: The Answer(s) provided above are for general information only. The attorney providing the answer was not serving as the attorney for the person submitting the question or in any attorney-client relationship with such person. Laws may vary from state to state, and sometimes change. Tiny variations in the facts, or a fact not set forth in a question, often can change a legal outcome or an attorney's conclusion. Although AttorneyPages.com has verified the attorney was admitted to practice law in at least one jurisdiction, he or she may not be authorized to practice law in the jurisdiction referred to in the question, nor is he or she necessarily experienced in the area of the law involved. Unlike the information in the Answer(s) above, upon which you should NOT rely, for personal advice you can rely upon we suggest you retain an attorney to represent you.

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