What to Do if Your Insurance Claim is Denied

Nearly everyone carries one or more types of insurance policies designed to bring peace of mind, whether it’s medical or life insurance, auto insurance, homeowners or business insurance. Should unforeseen events occur, you expect the insurance company to have you covered; but what happens if, when the time comes, your claim is denied?

Fortunately, you don’t have to give up on insurance claims that are turned down. There are several steps you can take to ensure that your policy’s coverage is enforced, and that you receive the funds or services you’re owed.

Typical Reasons Given for Denying Insurance Claims

An insurance company will turn away claims for a number of reasons. Some of the most common reasons given include:

  • The policy was not in effect at the time of the incident being claimed
  • The claim was filed too late, or not in a timely manner
  • There are policy exclusions for the incident
  • A provision of the insurance contract was breached or not met
  • The claim is not covered under the type of policy you hold

Whenever an insurance claim is denied, the insurance company is obligated to give you a reason for turning down your claim. Legally, an insurance company has to act in “good faith” when claims are submitted. This means they must investigate every claim carefully and pay the coverage amount within a reasonable time.

How to Dispute a Denied Insurance Claim

If you receive an insurance claim denial, your first step should be to ask the insurance company for a reason, in writing. Next, you should go over your insurance policy carefully, to make sure that your claim should be covered under the terms.

Once you’ve verified that your claim should have gone through, you’ll need to let the insurance company know in writing that you want to appeal the claim. In addition, include a written explanation of why the incident should be covered, and any supporting documentation you have.

For insurance companies with complicated processes, you may want to hire an experienced insurance attorney to help you file your claim denial appeal.

Insurance Companies and Bad Faith

Despite the legal requirements, some insurance companies don’t always act in good faith. Some examples of insurance bad faith include:

  • Failing to process a claim in a reasonable amount of time
  • Not conducting a reasonable investigation before denying a claim
  • Refusing to provide a reason for denial of a claim
  • Delaying the payment of a claim for an unreasonable length of time
  • Undervaluing and under-paying a claim
  • Raising premiums unfairly
  • Wrongfully cancelling a policy

If an insurance company is acting in bad faith, your best course of action is to contact an attorney who is experienced with insurance law.

The Miami trial lawyers at Baron, Herskowitz, and Cohen have successfully represented many clients struggling with bad faith insurance and denied insurance claims, and have helped them get through insurance nightmares. If you are struggling with your insurance company, contact us today to discuss the details of your insurance case.