Best Way to Deal with an Insurance Company that Denies a Claim

woman looking at a letter

The insurance company is legally obligated to pay your claim if you have a valid insurance policy and make a valid claim. However, there are times when insurance companies wrongfully deny claims or stall in paying claims. If this happens to you, there are certain steps you can take to try to get the insurance company to pay your claim.

First, examine why an insurance company might refuse to pay a valid claim. Some of the most common reasons include the following:

The Insurance Company Says Your Policy Doesn’t Cover the Loss

You should review your policy carefully to determine if the insurance company is correct. If you believe the insurance company is wrong, you can ask them to provide a written explanation of their decision. You can also ask them to review your policy again.

The Insurance Company Claims You Didn’t Give Notice of the Loss

Most policies require that you give notice of the loss as soon as possible to allow the insurance company to investigate the cause and determine whether it is covered under the policy. In case of a dispute, it is important to have documentation to show that you gave notice of the loss on time.

The Insurance Company Claims You Don’t Have a Valid Policy

Suppose you believe you have a valid policy. In that case, you should request that the insurance company provide you with a copy of the policy. If the policy cannot be located, the insurance company may still be liable if you can prove that you had a valid policy.

The Insurance Company Denies Your Claim Based on Exclusions in Your Policy

Most policies exclude certain types of losses from coverage. In this case, the insurance company may be correct in denying your claim. However, you may be able to argue that the exclusion does not apply to your particular loss.

What Can You Do If Your Claim is Denied?

If your claim is denied, you should take the following steps:

  1. Review your policy and ensure you understand what it covers and excludes. If you have any questions, ask your agent or broker for clarification.
  2. Write a letter to the claims department requesting that they reconsider their decision. Include all relevant information about your claims, such as the date of loss, police reports, repair estimates, and photos. Be sure to include a copy of your policy and any other supporting documentation. Keep a copy of your letter for yourself.
  3. Send your letter via certified mail with the return receipt requested so that you have proof that the insurance company received it. Keep copies of everything for your records.
  4. If the insurance company denies your claim, write another letter requesting to reconsider their decision and explain why you believe they wrongfully deny your claim.

Ensure all supporting documentation and send it via certified mail with the return receipt requested as proof that the insurance company received it. If the insurance company still denies your claim after receiving your second letter, contact an attorney who specializes in insurance law for further assistance.

close up of gavel male lawyer or judge consult with client

When to Take Legal Actions?

If you’ve taken all the steps to try to get the insurance company to pay your claim, but they continue to deny it, you may have no choice but to take legal action. An insurance lawyer can help you determine if you have a valid case against the insurance company and represent you in court if necessary.

If the case is complex, consider filing a class action lawsuit against the insurance company. Class action lawsuits allow a group with similar claims to join and file one lawsuit. This can be a more efficient and cost-effective way to seek damages from an insurance company.

What Your Lawyer Can Do for You

Your lawyer will review your claim and the insurance policy to determine if you have a valid case. If you do, your lawyer will gather evidence to support your claim and build a strong legal argument. Your lawyer may also negotiate with the insurance company on your behalf to try to reach a settlement agreement.

Your lawyer will take your case to trial if a settlement cannot be reached. At trial, your lawyer will present evidence and argue on your behalf to get the judge or jury to rule in your favor. Be ready to present your case to a judge or jury if your lawyer believes it has a good chance of success.

Filing a Lawsuit Against an Insurance Company

If you decide to file a lawsuit against your insurance company, you should know a few things.

  • You will likely have to pay a filing fee to the court when you file the lawsuit.
  • You will need to serve the insurance company with a copy of the lawsuit. This can be done by mailing it to the company’s headquarters or hiring a professional process server to hand-deliver it. Once the insurance company has been served, they will have time to respond to the lawsuit.
  • Your lawsuit will be governed by the laws of the state where it is filed. This means you must follow the rules and procedures of that state’s court system.
  • If you win your case, the insurance company will likely be ordered to pay your attorneys’ fees and court costs in addition to any damages.
  • If you lose your case, you may be responsible for the insurance company’s attorneys’ fees and court costs.

In the End

When dealing with an insurance company refusing to pay your claim, it can be frustrating and confusing. However, following the steps outlined in this blog post can increase your chances of getting the insurance company to pay your claim.

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