Have you been involved in a snowmobile, boat, or motorcycle accident? If you or a family member has been injured or killed because of another person’s negligence, or your property has been destroyed by fire or flood, you may be entitled to compensation from an insurance company. However, when dealing with insurance companies, the situation can be sticky business.
There are some cases when you might want to get an insurance attorney involved with your insurance claim. There are several reasons why you would want to do this, as you’ll see below.
Your Insurance Claim Rights; By Policy and Law
You have a right to expect the insurance company to handle your claim fairly and honestly. You also have rights under state law that may apply to your claim.
Insurance companies must follow their policies, which usually say how you must make a claim, what information you must provide and when you must submit it. These policies are called “claims-handling procedures” or “claims-handling rules.” Your insurer has the right to deny your claim if you fail to follow requirements.
On the fair side, you as a policyholder have the right to file an appeal if you believe that the denial of claim is not right.
Rejected insurance appeals have certain levels that require you to do certain processes and submit certain requirements, so when your first appeal is denied, you can guarantee to do it again on a different demand. Read on to know how to do an insurance claim appeal.
Despite submitting appeals and repeatedly denied, yet if you feel that the claim should be paid out, then you have grounds for an insurance claim denial lawsuit.
Insurance Claim Denial
Insurance Claim Denial is when the insurance company denies your claim.
If you file a claim with your insurance company, they are required by law to investigate it and determine if they will pay out on it or not. Failed to comply with their policies may subject you to insurance claim denial.
There are many reasons why an insurance company may deny a claim. The most common reasons are:
The policyholder did not properly disclose all relevant information regarding their circumstances at the time of purchasing the policy
The policyholder intentionally misrepresented or concealed relevant information about their circumstances at the time of purchasing their policy
The circumstances occurred immediately after the policy was issued
The policyholder failed to comply with an exam requirement (if one was included in their policy).
However, many people don’t realize that insurance companies sometimes deny legitimate claims. This can be a big problem for policyholders, as they may be left without the coverage they need in an emergency situation. In this case when you feel you are on the fair side, then this can be decided if you are eligible to file a lawsuit against your insurer.
Insurance Claim Appeal
You may have heard of the term “appeal” in regards to an insurance claim. If you have been denied coverage by your insurance company, you can appeal their decision.
What is an Insurance Claim Appeal?
An appeal is when you ask for a review of a policy decision by the insurance company. You may have been denied coverage for something like a home or auto claim, or you might have received less than what you expected on your claim settlement. In these cases, you can appeal the decision by asking for an explanation as to why they made their decision and what they would change if they could.
How Do I Appeal an Insurance Claim?
The first step in appealing a claim is to contact your agent or adjuster directly. If they cannot help you then try calling customer service or contacting the head office directly if necessary (this information should be on their website). Once you’ve taken these steps and still haven’t had any success then it’s time to hire an attorney who specializes in insurance claims (see our section on finding a lawyer).
Insurance lawyers will be able to guide you through the appeals process and make sure that everything is handled correctly so that you won’t lose your claim. If you want to appeal an insurance claim, be sure to do so as soon as possible. The longer you wait the less likely it is that your claim will be approved.
Claim Amount Depending On Damage
The claim amount depends on the damage. For example, If you are injured during a car accident, your insurance company will pay your medical bills and give you a percentage of your lost wages. The same goes for property damage. The insurance company will pay for repairs to the damaged vehicle and give you a percentage of your deductible.
The percentage is determined by the type of coverage that you have with your insurance policy. Typical amounts are:
Comprehensive Insurance – If you have comprehensive coverage, then the insurance company will pay for all damages that occur from such situations like an accident that is not caused by another driver or another person’s negligence. This also goes with other types of disasters like fire, theft, vandalism and other non-collision damages. Another inclusions are losses from natural disasters such as floods or earthquakes. Comprehensive coverage pays for losses up to the limits set by your policy.
Collision Insurance – Collision insurance pays for losses resulting from accidents with another vehicle or object. It does not cover loss due to fire, theft or vandalism unless they occur at the same time as an accident with another vehicle or object. Collision coverage pays for losses up to the limits set by your policy.
Liability Insurance – Liability insurance covers legal costs associated with injuries suffered by someone else and their property damage that you cause. It also covers legal fees incurred when someone causes an accident and then sues you. You must have liability insurance to get a driver’s license in many states.
Insurance companies have certain processes and requirements in order for you to get your claim. However, in some circumstances, you might be a victim of unlawful denial due to certain grounds, hence needing help from an insurance claim lawyer.If it is your case that the insurance company is not following their policy in some way you need to speak to a skillful insurance lawyer now because there are time limits which apply. By taking action on your own you cannot rely on what the other side says or does. You need professional insurance claim legal advice as soon as possible and with every day passing you may lose important rights to support your claim.