INSURANCE/CLAIMS

Insurance Claims

INSURANCE LAW

Insurance attorneys work with clients who have had their insurance claims denied or who are facing other issues with their insurance providers. Insurance attorneys can help clients understand their insurance policies, file claims, and appeal denied claims. They can also help clients who are facing bad faith claims by their insurance providers.

Bad faith refers to the failure of an insurance company to deal fairly and honestly with its policyholders. Insurance companies have a duty to act in good faith when handling claims. When an insurance company fails to act in good faith, it may be acting in bad faith. Bad faith can take many forms, including unreasonably delaying or denying a claim, failing to investigate a claim thoroughly, or failing to communicate with the policyholder about the status of a claim.

WHAT TO DO WHEN MY INSURANCE CLAIM IS DENIED?

There are many reasons why an insurance company may deny a claim, including:

  • The claim is not covered under the policy;
  • The claim was filed late;
  • The policyholder failed to pay premiums;
  • The claim involves a pre-existing condition;
  • The claim involves fraud or misrepresentation;
  • The damage was caused by an excluded event; and
  • The claim lacks sufficient documentation.

If your insurance claim is denied, you have the right to appeal the denial. The first step is to review the denial letter carefully to understand the reason for the denial. You should then review your insurance policy to see if the claim is covered. If you believe the denial was improper, you can file an appeal with your insurance company. If the appeal is denied, you may have the right to file a lawsuit against your insurance company.

If you believe your insurance company is acting in bad faith, you may have a claim for bad faith against your insurance company. Bad faith claims can result in the recovery of additional damages beyond the value of the original claim, including punitive damages.

WHAT EXACTLY IS BAD FAITH? HOW DO I KNOW IF MY INSURER ACTED UNFAIRLY?

Bad faith is the failure of an insurance company to act fairly and honestly in handling a claim. An insurance company acts in bad faith when it:

  • Unreasonably denies a claim;
  • Unreasonably delays processing a claim;
  • Fails to investigate a claim thoroughly;
  • Fails to communicate with the policyholder about the status of a claim;
  • Offers an unreasonably low settlement;
  • Misrepresents the terms of the policy; or
  • Fails to pay a valid claim in a timely manner.

If you believe your insurance company is acting in bad faith, you may have a number of legal avenues available to you, including:

  • Filing a complaint with your state's insurance regulatory agency;
  • Filing a lawsuit against your insurance company for breach of contract;
  • Filing a lawsuit against your insurance company for bad faith; and
  • Filing a class action lawsuit if other policyholders have been similarly treated.

It is important to consult with an insurance attorney as soon as possible if you believe your insurance company is acting in bad faith. An insurance attorney can help you understand your rights and options, and can represent you in any legal proceedings.

IS IT POSSIBLE TO TAKE LEGAL ACTION AGAINST MY INSURANCE PROVIDER?

Yes, it is possible to take legal action against your insurance provider. Insurance policies are contracts, and if your insurance company fails to honor the terms of the contract, you may have a claim for breach of contract. You may also have a claim for bad faith if your insurance company fails to act fairly and honestly in handling your claim.

Before filing a lawsuit against your insurance company, you should first exhaust your administrative remedies, including filing an appeal of any denied claim. You should also review your insurance policy carefully to understand the terms and conditions, and to determine whether the claim is covered under the policy.

If you decide to file a lawsuit against your insurance company, you will need to show that the insurance company breached the terms of the policy, and that you suffered damages as a result of the breach. You may also be able to recover punitive damages if the insurance company acted in bad faith.

WHAT LEGAL SOLUTIONS EXIST IN AN INSURANCE CLAIM LAWSUIT?

If you succeed in a lawsuit against your insurance company, you may be able to recover compensatory damages, which are designed to compensate you for your losses. Compensatory damages in an insurance claim lawsuit may include the value of the denied claim, as well as any additional losses you suffered as a result of the denial, such as medical expenses, lost income, and property damage.

In addition to compensatory damages, you may also be able to recover punitive damages if your insurance company acted in bad faith. Punitive damages are designed to punish the insurance company for its bad faith conduct and to deter similar conduct in the future. Punitive damages can be substantial, and in some cases can far exceed the value of the original claim.

WHEN TO HIRE AN ATTORNEY FOR INSURANCE CLAIMS?

You should consider hiring an attorney for an insurance claim if your claim has been denied, if you believe your insurance company is acting in bad faith, if the value of the claim is significant, or if you are having difficulty navigating the claims process. An insurance attorney can help you understand your rights and options, gather evidence, negotiate with your insurance company, and represent you in any legal proceedings.

Call our office today at (833) 388-7044 or complete the convenient online contact form to set up a consultation.