If you need to file an insurance claim, you cannot trust the insurer to act in good faith. That is not how these companies work. Every day individuals must deal with an insurance company reducing, delaying, or denying their claims.
If you are in this position and find yourself in a dispute with the insurance company after filing an insurance claim, you may pursue legal action to obtain the money you need. Better yet, with an insurance claims lawyer from the law firm of Dolman Law Group Accident Injury Lawyers, PA, fighting for your rights, you will not have to take on this complicated legal ordeal alone.
Dolman Law Group Accident Injury Lawyers, PA—About Us
At 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 Work
An 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.
These claims can cover everything from comprehensive medical exams to death benefits. We can review your insurance policy for you and tell you what it covers. If you do not understand why an insurance company will not cover your claim, reach out to our knowledgeable insurance lawyers. We can verify what your policy includes.
The Different Reasons an Insurance Company Denies an Insurance Claim
Most 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.
For these reasons, if you believe an insurance company denied your claim unfairly, contact an experienced insurance lawyer, such as those at the Dolman Law Group Accident Injury Lawyers, PA. These legal professionals can review your claim, determine if the insurer is liable for unfairly denying it, and help you pursue the compensation you need.
The Damages You Can Recover When You Sue the Insurance Company
If 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:
These damages refer to payment for the actual losses that result from the incident, including:
The loss of the use of a motor vehicle or the home
The loss of job opportunities
The costs of the suit and lawyer fees
Money for all the losses resulting from unpaid insurance benefits
These damages refer to payment for the subjective losses that result from the incident and the insurance company's conduct, including:
Pain and suffering
You may also pursue punitive damages depending on the facts of the case. While the above damages make the victim whole after an incident, punitive damages penalize the wrongful party for their egregious actions and prevent other parties or entities from doing the same. Consequently, these damages are not awarded in each case but are limited based on the state and court regulations.
Protecting Your Legal Claim When Suing the Insurance Company
After an insurance company denies your claim, the situation may feel overwhelming and stressful, especially as you determine your next steps. However, if you pursue legal action against the insurance company, remember that the process of holding the insurance company accountable is not easy, and you must prepare when taking on these companies. That is why you should:
Document All Communication
When you communicate with the insurance company, keep a copy of all correspondence, whether by email or phone. Just ensure this information is detailed. For instance, if you are taking a call with the insurance company, stay calm, write down the date, time, and name of the representative you speak to, and include everything you discuss.
Keep Track of Expenses
You want to keep a detailed record of all your expenses, including your lost wages, attorney fees, property repairs, and medical bills. However, make sure you also keep a copy of all the receipts associated with these costs.
You will also want pictures from the incident, including photos of the damage to your property and yourself immediately after the accident.
Reach out to an Experienced Insurance Attorney
Taking on insurance companies requires strong legal skills and knowledge of how insurance companies work. For these reasons, reach out to an experienced insurance attorney who has previously handled these claims.
When you meet with these lawyers, discuss everything that happened, and provide them with all the evidence you collected, including receipts, photos, and correspondence with the insurance company. Your attorney can use this evidence to prepare a strong legal case and go after the justice and compensation you deserve after the insurance company has denied your claim.
Plus, because most of these lawyers work on a contingency fee basis, you will not have to pay out of pocket for your attorney. Instead, these lawyers will only receive a percentage of the benefits they recover from your insurance provider, which means they will not get compensated if you do not get paid.
Contact a Insurance Claims Attorney Today
Dealing with the insurance company can be a challenging ordeal. Thankfully, you do not have to do it on your own.
If you are facing an insurance dispute, contact the Dolman Law Group today at 833-552-7274 for a free consultation and let our attorneys help you go after the money you deserve.
Personal Injury Lawyer
This article was written and reviewed by Matthew Dolman. Matt has been a practicing civil trial, personal injury, products liability, and mass tort lawyer since 2004. He has represented over 11,000 injury victims and has served as lead counsel in over 1000 lawsuits. Matt is a lifetime member of the Million Dollar Advocates Forum and Multi-Million Dollar Advocates Forum for resolving individual cases in excess of $1 million and $2 million, respectively. He has also been selected by his colleagues as a Florida Superlawyer and as a member of Florida’s Legal Elite on multiple occasions. Further, Matt has been quoted in the media numerous times and is a sought-after speaker on a variety of legal issues and topics.