Make sure to ask your insurance company for the reason it is delaying payment of your claim, and ask them to put this reason into writing and send it to you. You will need this as evidence later on.
Make sure to ask your claims adjuster for the reason the insurance company is only willing to pay you such a low amount, and get this reason in writing. You will need this later.
Make sure to have your insurance company give you the reason it is denying your claim in writing so you will have this for reference later on.
To recognize this type of behavior, check to see which part of the insurance company is processing your claim—the claims department or the underwriting department. [4] X Research source If it is the latter, be on the lookout for your insurance company taking this type of action against you. If your insurance company issues you a check refunding your premium payments because they are canceling your insurance, do not cash this check. [5] X Research source Doing so may be seen as accepting the insurance company’s decision to cancel your insurance in light of a claim it does not want to pay.
If your insurance company fails to defend you when they were supposed to, you may sue for “bad faith” and recoup the costs of defending yourself. These costs could include attorneys fees for both defending yourself and suing the insurance company. [6] X Trustworthy Source American Bar Association Leading professional organization of lawyers and law students Go to source
Many of the above activities could also be considered a breach of contract, meaning your insurance company has violated the terms of the insurance policy it offered you and on which you have been paying premiums. These activities may also be considered a violation of federal or state consumer-protection law, which prevents businesses from engaging in unfair or deceptive business practices, or from making fraudulent statements. [8] X Research source These laws vary by state but, generally, if your insurance company has made false statements to justify any of its actions, you can bring your lawsuit on this ground as well.
Ask why your claim was denied, and get the reason in writing. You will need this as evidence later if you intend to sue your insurance company.
Make sure you have complied with your contractual obligations. If you will be asserting that your insurance company has failed to follow through with its contractual duties, you will want to be sure that they cannot make the same claim against you. If your policy states the process by which you must submit a claim, for example, follow this process exactly.
If you have spoken with your insurance company about your claim, collect the records of these conversations (written correspondence, e-mails, etc. ) so that you will be able to show you have taken steps to resolve your claim before resorting to litigation.
The website for your state’s department of insurance will also contain resources to help you understand your state’s insurance law. You should be aware that most state’s insurance departments receive many claims each day, and therefore you may have to wait a considerable amount of time before your dispute is finally resolved. If you want quicker results, consider hiring an attorney. If you do hire an attorney, some states’ insurance departments will wait until your attorney has litigated your case before intervening. [13] X Research source
Attorneys often accept insurance cases on a contingency-fee basis, meaning they will take a portion of the money you are awarded if you win as payment instead of you paying them up front. [15] X Research source You will be charged nothing if you lose your case. The attorney will also be able to sit down with you and discuss the issues of your particular case to determine the best way to handle your denied claim. Many attorneys offer free consultation, so don’t be afraid to take advantage of this and talk through the facts of your case with someone who specializes in your state’s insurance laws. Your attorney will take care of the lawsuit as it progresses, and will contact you as needed for more information.
Your insurance company will file an answer to this complaint, and your attorney will receive a copy. From this document, you will be able to get a general idea of what your insurance company’s position is.
This is where your written correspondence with the insurance company will come in handy. If you don’t have certain information about your case that you think the insurance company has in its records, this is the time to ask for this information. The insurance company will also ask you for certain records and documents, which you must produce. During this process, the insurance company might depose you, which means that it meets with you and your lawyer in an official setting to ask you questions pertaining to your case. Most cases are settled in this stage. If you have a valid claim, and your insurance company sees that you are willing to take legal action to protect your interests, it will likely offer to settle your case with you to save itself the expense of trial.
