In 2019, I authored a monthly column in Insurance Journal magazine that consisted of a 12-part series based on my book “When Words Collide: Resolving Insurance Coverage and Claims Disputes.“ Below is a listing of, and link to, each column.
Needless to say, there is far more detail, including about 160 real-life claim examples and 80 court case citations, in the 365-page book which is available in print and Kindle editions on Amazon. Simply search for “when words collide” on Amazon or CLICK HERE. The book’s Amazon rating is 4.9 out of 5.0 stars and Brian Tracy on BookAuthority.com rates it the #5 insurance book of all time.
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Once Upon a Time … Resolving Insurance Coverage and Claims Disputes by Bill Wilson | January 7, 2019 An introduction to the 12-part series and why it’s important to understand that insurance is NOT a commodity. |
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What It Takes to Successfully Resolve Insurance Coverage and Claims Disputes by Bill Wilson | February 4, 2019 Four reasons why claims are denied: (1) they’re not covered, (2) illegal and/or unethical reasons, (3) “cranial inversion”, and (4) legitimate differences of opinion. |
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Two Ways to Deal with Claim Disputes by Bill Wilson | March 4, 2019 Avoidance and resolution, plus two foundational principles of insurance involving the purpose and mission of the industry. |
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Resolving Insurance Coverage and Claims Disputes by Bill Wilson | April 1, 2019 Seven factors in preventing claim disputes, including three sources of coverage gaps that can lead to claim disputes. |
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Resolving Insurance Coverage and Claims Disputes: Advocacy by Bill Wilson | May 6, 2019 Moving from prevention to resolution, a four-step process for resolving disputed claims…OK, make that five steps. |
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Resolving Claim Disputes: Step 0 by Bill Wilson | June 3, 2019 The claims resolution process…Step 0, quality controlling the claim denial (even uncovered claims can be improperly denied). |
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Resolving Claim Disputes: Step 1…The RTFP Doctrine by Bill Wilson | July 1, 2019 The dispute resolution process…Step 1 and the RTFP! Doctrine, plus policy peddlers vs. problem solvers. |
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Resolving Claim Disputes: Step 2…Other Policy Interpretation Doctrines by Bill Wilson | August 5, 2019 Step 2 and some policy interpretation doctrines such as contracts of adhesion, burdens of proof, clear and conspicuous exclusions, duty to defend vs. duty to indemnify, and folklore is not fact. |
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Resolving Claim Disputes: Step 3…Research and Document the Interpretation – Part 1 of 3 by Bill Wilson | September 16, 2019 Legal and contractual principles, including contra proferentum, tergiversation, and semantic vs. syntactic ambiguities such as noscitur a sociis and ejusdem generis. |
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Resolving Claim Disputes: Step 3…Research and Document the Interpretation – Part 2 of 3 by Bill Wilson | October 7, 2019 Legal and contractual principles, including intent vs. expectations, parol and extrinsic evidence, illusory coverage, public policy, reformation and rescission, and substantial performance. |
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Resolving Claim Disputes: Step 3…Research and Document the Interpretation – Part 3 of 3 by Bill Wilson | November 4, 2019 Legal and contractual principles, including entirety of contract, unconscionable advantage, waiver and estoppel, statutory supersession, agency accommodations, and regulatory directives. |
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Resolving Claim Disputes: Step 4…Plead Your Case by Bill Watson | December 16, 2019 The concluding column in the 12-part series addressing language vs. logic, Dalton’s 3 rules of claim negotiation, appealing a claim denial, and some final words. |
Again, there is far more detail, including about 160 real-life claim examples and 80 court case citations, in the 365-page book which is available in print and Kindle editions on Amazon. Simply search for “when words collide” on Amazon or CLICK HERE.
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Bill Wilson
Founder at InsuranceCommentary.com
One of the premier insurance educators in America on form, coverage, and technical issues; Founder and director of the Big “I” Virtual University; Retired Assoc. VP of Education and Research from Independent Insurance Agents & Brokers of America.
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