What to Do When an Insurance Company Refuses to Pay Your Claim

What to Do When an Insurance Company Refuses to Pay Your Claim

Dealing with an insurance claim, whether it is after a car accident or experiencing an injury, can be a stressful process. There are claim documents to fill out and receipts to send in. You want to make sure that you do everything right so you can get the compensation that is needed to pay off your expenses. Unfortunately, not every claim is paid out by the insurance company.

When this circumstance happens, you may feel completely discouraged. You might even give up on your claim while trying to figure out how to pay for all your medical bills and damages out of your own pocket. Yet you shouldn’t immediately give up on the insurance claim process. You do have options where you can appeal the denial and try to get the insurance company to pay the entire compensation amount.

Figure Out Why the Claim Was Denied

There are many reasons why an insurance company could deny a claim. It may be as simple as making a mistake on the forms. Other reasons could involve that you filed the paperwork past the specified deadline, the policy has lapsed, or there is an exclusion to the policy that impacts your claim. The insurance company may simply want more information, or they are not willing to pay the full amount. Once you know why the insurance company doesn’t want to pay the claim, you can take the right steps to rectify the situation to your benefit.

Send in the Required Documentation

Always make sure to have all the documentation that is required to prevent a denial from the insurance company. They may want to understand why you paid certain damages to your car or home, or why you received a certain procedure from a medical professional. This circumstance also happens frequently when you are requesting a certain amount of compensation but the insurance company wants to pay a lesser amount. By having thorough documentation, and copies of your documentation for your own records, you can ensure that the insurance company has all the documents that are needed.

Keep Details About Who You Talked with at the Insurance Company

With all the back and forth emails, phone calls and letters, you most likely will speak to a lot of different people at the insurance company. After a time, it can feel like you are just going through an endless, hopeless loop of denials and deflections. Make sure to write down the name of the person you spoke with, the time of the call, and take notes of the conversation. These details will benefit you if you hit a roadblock and will later need to take more legal action against the insurance company.

Send in a Demand Letter

If your claim was denied by another person’s insurance company, such as the liable party after a car accident, you can send the other insurance company a demand letter. The demand letter should outline all details of your claim, such as what occurred that requires you to file for compensation, what damages or medical expenses you have, and why the other person is at fault for the damages or medical conditions caused by the accident.

You can have a personal injury attorney help you draft the letter. The attorney’s law firm may carry enough weight to convince the insurance company that you are serious about the claim and will take further action if needed.

Go Through the Formal Appeals Process and Arbitration

If you tried talking with the insurance company to provide them with all the information about the accident or damages and they still deny you, you may be able to go through a formal appeals process. There are some states that are required by law to offer an appeals process or arbitration. Going through arbitration may help you get a settlement, although the process can be complicated depending on how the insurance company has their appeals process set up as well as the deadline on when you can make a formal request.

Filing a Lawsuit

Filing a lawsuit is usually the last option on the list when you are trying to get the insurance company to pay for your claim. Keep in mind that the costs of filing the lawsuit and going to court could be more than the insurance compensation that you are seeking. Getting the necessary legal advice throughout the entire process can help you make the best decision based on your particular circumstances.

If you had an insurance claim denied in Long Island, turn to the personal injury attorney firm of Siler & Ingber, LLP. Fully experienced on handling insurance companies and claims, we can help you file for compensation as well as go through the appeals process so you receive the right settlement amount.

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