Dolman Law Group Accident Injury Lawyers, PA—About UsAt the Dolman Law Group Accident Injury Lawyers, PA, our legal team gets clients results while providing them the exceptional services they need. When you reach out to us, we make it a point to meet one-on-one to review your case. We work directly with you to ensure we handle your claim appropriately while fiercely fighting for the money you deserve. Because of our dedication to each of our clients, we have helped countless individuals and secured millions of dollars through settlement negotiations and jury verdicts on their behalf. We have also been nationally recognized as “Clients Choice for Personal Injury” by AVVO. For these reasons, if you suffered harm in an accident and require legal help, contact us today for a free case evaluation. We are not only a Florida law firm but a national one, and we serve clients all over the country, meaning all you have to do is find an office near you and reach out to discuss your case.
How Insurance Claims WorkAn insurance claim is the policyholder's formal request to the insurance company to recover compensation for a covered loss or policy event. Once the insurance company receives this request, they will review it and either validate it or deny it. If the insurer approves it, they will issue payment once the policyholder pays the deductible. While several situations give rise to an insurance claim, the below claims are some of the most common:
- Auto insurance: If you are involved in a car crash with another motorist, someone steals your car, or a collision or a natural disaster damages your vehicle, you can file an auto insurance claim to recover compensation for these damages.
- Homeowners insurance: If your home a fire, storm, or vandalism damages your home, you may file a homeowners insurance claim to obtain compensation for your losses. However, this insurance typically does not cover every disaster that can destroy your home, like floods and landslides. Rather, you must get separate coverage to protect your home against these risks.
- Health insurance: You make a health insurance claim every time you receive medical care or fill a prescription covered by your insurance.
- Life insurance: If a person dies and has a life insurance policy, their beneficiaries can file a claim with the insurer to receive the policy's proceeds.
- Workers' compensation insurance: If you are injured or become sick at work, you can file a workers' compensation claim to receive medical and wage benefits.
The Different Reasons an Insurance Company Denies an Insurance ClaimMost people believe the insurance company wants to help them after an accident, primarily since this is the purpose of having insurance and paying premiums. However, this is not how these companies operate. Like other businesses, the insurance company wants to make a profit. By offering you less or denying your claim, they make more money. These insurance companies and adjusters will have a stockpile of reasons for denying your claim. Yet, while some of these reasons may be legitimate, many are not. Consider the following common reasons that the insurance company may deny an insurance claim:
- An error with the claim: Check your policy after an accident to review the rules regarding notifying the insurance company. Some insurance companies have timelines that require you to submit a claim within 24 hours. If you don't, the insurer will deny the claim.
- An error with the application: Some insurance companies may argue that you made an error when you filled out your insurance claim application and, as a result, will deny your claim.
- A lack of coverage: Depending on the circumstances of the incident, the insurance company may argue that their policy does not cover your claim.
- A bad faith denial: A bad faith denial typically involves the insurance company refusing to pay an insurance claim without a reasonable basis. Instead, they will issue a denial by using confusing policy jargon to hide the fact they do not have a reason to deny your claim. On the other hand, they may have a reasonable basis for denying, but if they fail to properly investigate the claim promptly, it can still be a bad faith denial if they reject the claim.
What Legal Action Can You Take Against the Insurance Company?If an insurance company does not uphold the terms of your insurance policy, you may take them to court for breach of contract, especially when you have always paid your premiums and properly filed your claim. In addition, depending on the circumstances of the incident, you may also pursue a bad faith tort lawsuit. For instance, if you discover that the company outright manipulated the terms of its policy to avoid paying you the money you deserve, this could warrant a bad faith suit. To understand your legal options and determine whether you can bring one of these claims, it is often in your interest to reach out to an experienced insurance attorney. Our skilled insurance lawyers from the Dolman Law Group Accident Injury Lawyers, PA, can review what happened, check the state's rules regarding your claim, determine your legal options, and go after the financial damages you deserve.
When Can You Sue the Insurance Company for a Denied Claim?Insurance companies are not only obligated to pay compensation for fair claims submitted by policyholders, but they must also follow the terms specified in the contract, act in good faith of the agreement, and avoid unfair tactics. As a result, when the insurance company does not meet these standards and denies your claim, you may have a reason to sue the insurance company, especially if they:
- Do not conduct a proper investigation into the claim.
- Delay the investigation.
- Do not approve the claim within the agreed-upon timeframe.
- Do not explain why they denied the claim.
- Refuse or deny to pay the claim where liability is reasonably shown.
The Damages You Can Recover When You Sue the Insurance CompanyIf you bring a lawsuit against the insurance company, you may recover compensation. This compensation will often depend on the state rules, your policy, and the facts of the case. You may recover the following types of financial damages:
Economic DamagesThese damages refer to payment for the actual losses that result from the incident, including:
- Medical bills
- Lost wages
- The loss of the use of a motor vehicle or the home
- Property damages
- The loss of job opportunities
- The costs of the suit and lawyer fees
- Money for all the losses resulting from unpaid insurance benefits
Non-Economic LossesThese damages refer to payment for the subjective losses that result from the incident and the insurance company's conduct, including:
- Emotional anguish
- Pain and suffering