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Legal Help in Insurance Claim Disputes: What to Do if Your Claim is Denied

Posted in Blog on May 2, 2019

Contrary to what it may feel like, your insurance company works for you. So if you feel that your insurance company, whether it be car, home, or health insurance wrongfully denies a claim you submit to them, speaking to an experienced personal injury lawyer can make all the difference. When you sign a contract with your insurance company, you both agree to operate under the contractual stipulations of the insurance policy you select. Your insurance company is supposed to support you during a difficult time in your life, whether it be injuries you sustained in an accident, cost of repairing your house after a disaster, or for seeking medical attention covered under your insurance. A lawyer will help you determine if the claim the company denied was rightfully rejected and help clarify their justifications for doing so, and if the insurer wrongfully rejected your claim, your lawyer can help you pursue legal action.

When you enter into an agreement to work with an insurance company, the insurer is obligated to investigate the circumstances of your claim, be in reliable and frequent communication with you about the status of your claim, and remit payment to you as soon as possible once your claim has been resolved. If your insurer fails to uphold any of these obligations, you may very well be entitled to file a claim against them, and you may be further entitled if they do not uphold these obligations in a timely manner. However, there are several reasons your claim may rightfully be denied:

  • Disputed liability, in which the insurance company claims that the accident did not cause your injuries or damages after investigation.
  • Policy exclusions, in which a company is entitled to list circumstances that they will not cover. Be sure to check the details of your policy before pursuing action against your insurer.
  • Lapsed policy, in which your insurer may deny your claim based on premiums not having been paid, which caused a lapse in policy at the time of the accident.
  • Failure to notify the insurer, in which you neglect to report your claim to your insurance company within a time frame they stipulate in your policy details.

However, if none of these circumstances apply and your claim is still being denied, you may be entitled to pursue legal action against the company. If your insurer performed any of these actions, considered improper claims practice, you should get in touch with an experienced attorney:

  • The insurer misrepresented details about coverage
  • The company did not attempt to settle claims in good faith when liability became clear
  • The insurance company did not promptly correspond or answer your correspondence
  • No reasonable action was taken to investigate the claim
  • Your claim is settled for less than what it should be settled for

If you have a claim that was denied, nearly every insurance company has a process of appeals that you can go through before you enter a legal battle with the company. You should still seek the help of an experienced attorney at this time, who can aid in stating why your claim should be paid under the terms of your policy and negotiate with the company for a settlement in your favor. If the appeal is denied or rejected, a lawsuit may be filed, you will definitely want an experienced lawyer on your side who can help you recuperate what you lost because of the accident. If you have an insurance claim that you feel has been denied for the wrong reasons, be sure to reach out to an experienced legal team in Denver who can help you through your claims process.

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