February 20, 2018
What if Your Insurer Won’t Pay?
Here are the things to do legally if you’re having problems with your insurance company paying out.
Disclaimer: If you have problems with insurance payouts, the following information only works as general guidance as to the legal process. It does not, however, function as actual legal advice about the matter. To further understand the legal aspect of insurance payouts, it’s best that you approach a licensed attorney who has experience in insurance claims lawsuits similar to yours.
When you’ve been in an accident, the next big thing to do is to file your insurance claims with your insurance company. In fact, you’re somehow relieved because you are hoping that you’ll be paid for all your financial losses as a result of the accident. You’ve submitted your claim on time — only to find out that you’re having a difficult time getting your insurance claims paid by your insurer. You’re now behind on your bills and don’t want to ruin your credit score or, worse, need to file for bankruptcy. So, here are the things to do legally if you’re having problems with your insurance company paying out.
Reasons Why You’re Having Trouble Getting Your Insurance Claims
It’s difficult to think that your insurance company can deny your claim or decline to pay the amount you’re expecting for. Below are some of the reasons why your insurance provider can refuse or does not pay the whole amount you’re asking for:
- Check if you’ve stated the facts in your documentation properly. Remember, insurance companies may conduct their own investigation on your application, so it’s best that you provide them with documents that are valid and up to date.
- Make sure you follow the right processes in terms of filing your claims. If you’ve skipped a step or missed a requirement, you may end up going back to square one.
- It’s important to see if you’re up to date with your payments for your insurance. Sometimes, insurance companies disregard applications for claims because applicants have failed to complete their payments.
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Things to Do Legally When You Have Problems With Your Insurer Paying Out
These are the things to do legally when you have problems with your insurer paying out:
1. Know What Insurance Claims Your Policy Covers
- Make sure that what you’re asking for applies to your active and existing insurance policy.
- Ensure that your insurance claims are not included in the exclusion clause of your policy
2. Keep All Your Communications and Documents Intact
- Note the procedures you have to go through to file an insurance claim. If you can get information as to how long a particular process can take and if there are specific deadlines, do so to get a general idea on the timetable of your claim.
- Remember that keeping documents can save you from any accusations your insurance company may throw at you.
- Note the requirements and other documentation you need to comply with. If you have these documents, make sure you have copies and don’t lose the original versions. These can be useful if ever you have to present these to experts, or if you have to take your claim to the court.
When you’re beginning to experience problems with your insurance applications, take a deep breath and try to be more persistent regarding your follow-ups and inquiries. If you think you need to learn more about your particular issue, you may want to consider hiring an experienced lawyer.
3. Get a State Insurance Regulator or a Lawyer: When problems arise with your insurance provider, it’s essential that you settle the dispute among yourselves in a calm and patient manner. However, if you still end up having difficulties, you may ask the assistance of a state insurance regulator or a lawyer.
- When hiring a state insurance regulator or a lawyer, note their particular specialization and make sure they’re appropriate for the kind of issue you’re tackling. Try to inquire if they are aware of certain policies in your state, as some laws vary depending on where you reside.
- If you get a state insurance regulator or a lawyer, use this opportunity to get to learn everything you can about your particular issue, to avoid encountering the same problems in the future.
4. File a Lawsuit: Your last remedy could be the filing of a lawsuit. The things to keep in mind are:
- Hire a licensed lawyer who has experience in insurance lawsuits.
- Prepare for the deposition (under oath) and trial, where you have to present documentation to validate your claim.
- Wait for the final judgment – The jury will resolve the case in one party’s favor. If the result does not favor your side, speak to your lawyer for a possible appeal. Remember, just because the decision doesn’t favor your side, it doesn’t mean it’s too late for your insurance payment.
See also: ‘It’s Life, Jim, but Not as We Know It’
If you feel that your legal rights have been violated by your insurer, don’t hesitate to practice your rights under the law. Check your state laws and initiate the appropriate course of action.