Having your insurance claim denied can be shocking. But keep in mind that many insurance companies are dishonest and find means to refuse claim resolutions rather than pay them. These unethical practices can include making you wait and asking for unreasonable demands. All in the hope that you'll give up and accept the denial. Here's what you need to know about your rights after having your insurance claim denied
What Your Insurance Company May Try to Do
Common unfair claim settlement schemes include: unjust policy interpretations, unfounded coverage determinations, and excessive demands for supporting documentation. Another common reason is the "ongoing investigation," which is simply a delay. So, after weeks or months of delays, you're at the mercy of your insurance company. You may not understand why your claim was denied and you remain without coverage.
You have the right to appeal an insurance denial. In fact, it's important to equip yourself with the knowledge of your own rights.
What Your Insurance Company Must Do
Florida protects the insured from insurance companies who act in bad faith. For example:
- Insurance companies must quickly recognize and act upon your insurance claim.
- An insured person must be updated on the insurance claim's advancement.
- Insurance investigations must be both timely and practical.
- Insurance claim resolutions must be realistic and rational.
The insurance investigation cannot contain unjust, excessive, and repeated demands for records and supporting data as a condition. The goal of any insurance claim is to reach a reasonable resolution, even if this means disputing the denial.
What to Do If Your Insurance Claim Was Denied
What should you do if you're on the receiving end of an insurance claim denial that is unjust? Start with the documentation.
Insurance policies must be interpreted by the insurance company to the advantage of the insured. For example, was the interpretation of your policy unbiased, honest and useful? Carefully examine your coverage if the insurance company issued the claim denial. Evaluate the text that specifically applies to the appeals and review process. Some insurance plans require certain conditions are met before additional actions. For example, before filing a suit against your insurance company.
An insurance company cannot dismiss your claim, or put difficult obstructions in your way or excessive conditions. To the contrary, your insurance claim must be resolved by the firm, and that resolution must be based on impartiality and fairness.
Contact the Law Offices of John D. Ameen, P.A. today to learn more about insurance claim denials and how to appeal or dispute them by calling (954) 763-4950.