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General

Your Options When Insurers Don't Act in Good Faith

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Insurance is a promise. When you buy an insurance policy, you pay monthly premiums up front, in exchange for which the insurer promises to full the policy later, paying your covered claims and communicating with you about its actions promptly.

Unfortunately, insurers don't always uphold their end of the bargain. When this happens, it is considered an act of "bad faith" by the insurer. It is essentially a form of consumer fraud.

Consumers who feel their insurance company may have acted in bad faith have legal rights. Our Ohio state law governing unfair trade practices prohibits insurers from being unfair to customers . Among the things insurers can't do:

  • Mislead you about what's covered in your policy
  • Make a payment, settlement, or payment offer that doesn't include all amounts due, without adequate explanation
  • Deny a claim due to a specific provision in your policy, without naming the relevant clause
  • Fail to acknowledge your written inquiry about a claim within 15 days
  • Fail to tell you within 15 days what documents you need to submit to substantiate your claim
  • Fail to take steps to investigate your claim within three weeks of receiving it
  • Offer claim or settlement amounts that are unfair
  • Ask you to accept a settlement that's less than the amount awarded to you in an arbitration
  • Fail to advise you if your claim has been accepted or rejected within 21 days
  • Fail to send a letter explaining why your case remains unresolved if it is still open 90 days after you file a claim

In general, courts want to see an insurer acting consistently and reasonably. For example, if an insurer singles out your claim for denial even though it's similar to many other claims the insurer approved on your insurance program, that could be viewed as unreasonable. If an insurer denies your claim while knowing there is no legal basis for that denial, it's said to be acting with reckless disregard -- another example of bad faith.

Another trick insurers may use to try to avoid paying your claim is known as post-claim underwiting -- that is, after you submit a claim, instead of paying the claim the insurer begins an investigation into whether you are really eligible for your already-issued insurance policy. Insurers are supposed to complete their investigation into your eligibility before they issue your policy. Starting an investigation after you file a claim can be a simple stall tactic to avoid paying your claim in a timely manner.

Post-claim underwriting has been on the rise nationwide. For instance, California levied millions of dollars in fines and required three insurers -- Blue Cross, Blue Shield and Health Net -- to restore coverage to thousands of customers in that state whose policies were rescinded after post-claim underwriting investigations.

As you can see, the laws governing insurers' behavior are complicated. If you believe you may be a victim of an insurance company acting in bad faith, contact the consumer-fraud attorneys at Stepter Law Office to learn more about your rights.

 

What Employees Need to Know About Non-Competition Clauses

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Non-compete clauses have grown increasingly popular in recent years, as companies seek to keep employees from leaving to work for competitors. Years ago, only senior executives were asked to sign non-competes, but now many companies ask all their workers to sign one.

A non-compete may be a section in a larger contract, or may be a separate contract of its own. Usually, the non-compete will specify a length of time during which you cannot work for competitors.

In many states, companies may legally require workers to sign a non-compete when they're hired. But know that your non-compete clause must be legally enforceable for the company to hold you to its terms -- and not all non-compete clauses will hold up if challenged in court.

In general, for a non-compete clause to be legal, companies that ask for a non-compete clause must give you something in return for surrendering your right to work for competing companies in the same field. Often, companies grant a signing bonus or stock options upon hiring when they require a non-compete clause, as compensation in exchange for the non-compete clause. If nothing is offered by way of compensation, a court could decide the non-compete clause was unreasonable and rule it invalid.

If you will be privy to inside information about the company -- their strategy, how their proprietary software works, what new products or services they are developing, their customer lists -- you may well be asked to sign a non-compete agreement.

You may also have signed a non-compete years ago, and now be wondering if you can accept a new job at a competing company. Often, working for a competitor will be a worker's easiest job transition, as they have directly relevant skills and experience. So it's no small matter to sign away that right in a non-compete clause.

If you've been asked to sign a non-compete agreement, or are wondering if one you've already signed is enforceable, the employment-law experts at Stepter Law Office can advise you. Contact our office for a free consultation.

 

Understanding Your Rights in an Employment-Related Contract Dispute

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It's easy to be confused about your rights under an employment-law contract. Some workers don't even know they have a contract, believing they are employed "at will" and can be terminated any time. But language in your employee handbook or a verbal agreement between you and your boss may establish a contract.

Even if you are an "at will" employee, you may be fired under circumstances that are illegal. For instance, if you are fired for reasons that violate federal discrimination laws, you may still have a legal case against your employer.

If you've been fired or feel you've been treated unfairly at work, you have a right to defend yourself. Common issues in employment contracts where a dispute can arise include:

  • breach of contract
  • severance pay and benefits due
  • non-compete agreements
  • ownership of patents or other intellectual property
  • termination or employment-separation agreements

Employment-contract lawsuits are often in the news, as workers fight for the right to return to their jobs or receive the compensation due them. For instance, recently Walmart was sued by a man fired from a Michigan Walmart store for using legally prescribed medical marijuana outside of business hours, to treat symptoms of his inoperable brain tumor.

Often, disputes arise because contracts are not well-written and don't clearly spell out workers' rights and responsibilities. This can create confusion and leave the contract open to more than one interpretation. Ever-changing federal, state and local laws mean employment contracts may also contain provisions that are illegal.

If you have have a disagreement with your employer about your contract, know your rights. A board-certified expert in employment law at Stepter Law Office can advise you about your options.

 

Family and Medical Leave Act (FMLA) and The Final Rule

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Under the 1993 federal law, eligible employees who work for covered employers are entitled to take up to 12 workweeks of unpaid leave in any 12-month period in order to: birth and care for a newborn child; adopt and care for a son or daughter; and/or take care of an immediate family member with a serious health condition. Eligible employees may also take unpaid leave under the Act if they have a serious health condition themselves and are unable to work.

In 2008, the Department of Labor (DOL) updated the Family and Medical Leave Act with “the final rule.” According to the DOL, the final rule was designed to improve communications between employers, employees and health care providers, as well as to address the military family leave provisions in the 2008 National Defense Authorization Act.

Key changes include:

  • The implementation of the Military Caregiver Leave provision, which grants eligible employees who are family members of covered servicemembers 26 workweeks of unpaid leave rather than the 12 workweeks provided under the original Act;
  • New guidelines for what constitutes a “serious health condition,” including the number of visits a person must make to a health care provider during the period of incapacity; and
  • An update to the “substitution of paid leave” provision that states that all forms of paid leave, including generic paid time off, are treated the same under the Act.

Additionally, employers can now meet notice requirements by providing employees with the following: a general notice about FMLA, an eligibility notice, a rights and responsibilities notice, and a designation notice.

To find out how the DOL’s final rule may affect you, contact the Ohio employment law attorneys at Stepter Law Office today.

 

Tip Pool Violations in Ohio

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Some employers require their tip-based, hourly employees to place a percentage of their tips into a collective pool. The pool is then divided among the tipped employees. This arrangement is often referred to as tip pooling.

Under federal law, employees who receive tips as part of their general compensation, such as wait staff, bartenders, bellhops and others, can be required to share and/or pool their tips if the following guidelines are met:

The percentage and/or amount of tips contributed to the pool must be customary and reasonable, and must not make any employee’s wage fall below the legal minimum wage;

  1. Tips must be fully redistributed;
  2. The redistribution of tips must follow a pre-arranged formula and must be consistent;
  3. Tipped employees cannot be forced to share their tips with others who do not customarily receive tips, such as kitchen staff and managers; and
  4. Employers cannot pay themselves out of the employee tip pool.
  5. Employers violate tip pool laws if any of the above conditions are not met.

At Stepter Law Office, we are dedicated to protecting the rights of employees who have been harassed, discriminated against, retaliated against, or otherwise treated illegally in the workplace. If you feel you have been forced to pool your tips unlawfully, please contact the Columbus, Ohio employment attorneys at Stepter Law Office today.

 

What At-Will Employment Means for Wrongful Termination Lawsuits in Ohio

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Ohio is an at-will employment state, which generally means that employers and employees can each terminate an employer/employee relationship without notice or cause. There are some exceptions to this rule, including terminations that violate either a contract between the employer and employee or public policy/legal statutes.

Employees who have a written employment contract or are members of a union with a collective bargaining agreement will typically have extra protections regarding their employment.

Common statutory violations include terminating an employee for any of the following: serving on jury duty; having court-ordered child support withheld from wages; filing for worker’s compensation; or “whistleblowing.” Discharging an employee for becoming pregnant or because of his or her age, race, sex, religion, handicap or national origin is also a violation of federal and state law.

Generally, for a wrongful termination lawsuit to have merit in Ohio, an employee must have been terminated in a manner that violated either a contractual agreement between the employee and employer or a legal statute. For questions regarding a particular employer/employee relationship, please contact our Columbus employment law attorneys.

 

What is “Whistleblowing”?

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A "whistleblower" is a person who reports illegal activity by his or her employer to governmental authorities. In order to help ensure employees speak up when they notice employer wrongdoing, laws have been put in place to protect "whistleblowers" from wrongful termination or retaliation by their employers. Retaliation may include: firing, demoting, refusing overtime, intimidation, reducing hours or reassignment of duties.

In Ohio, the Whistleblower Protection Act sets forth explicit instructions detailing how an employee must notify his or her company and the proper authorities of any illegal conduct, including when notifications must be made and to whom. If these instructions are not followed, the "whistleblower" may not be protected against termination or retaliation.

If you are have discovered illegal or improper conduct at your workplace, you should contact a qualified attorney knowledgeable in employment law and the Ohio Whistleblower Protection Act to ensure you understand and follow the necessary steps.

For more information, contact Columbus, Ohio Whistleblower Protection Lawyer Rayl L. Stepter.

 


Ohio Employment Law Blog

Your Options When Insurers Don't Act in Good Faith

Insurance is a promise. When you buy an insurance policy, you pay monthly premiums up front, in exchange for which the i...

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Stepter Law Office
1900 Polaris Parkway, Suite 450,
Columbus, Ohio 43240

Phone: 614.468.4100
Toll-Free: 800.873.0672
Fax: 614.468.4101

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1900 Polaris Parkway, Suite 450
Columbus, Ohio 43240
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