Whether it’s health, home, car, or life, you carry insurance for protection when something unexpected occurs. Insurance is designed to help you cover the cost of rebuilding your life, your home, your health, and even your car when something tragic occurs, And no one ever assumes the insurance they’ve paid for most of their lives will be rejected. Unfortunately, insurance claims are denied and rejected all the time for various reasons, but primarily because insurance companies want to pay as little as possible to protect their bottom line. Insurance companies will do anything not to pay a claim. If your claim is denied or rejected, you do have options.
Check the Information You Submitted
One of the most common reasons for denied insurance claims is misinformation. The paperwork you submitted when you filed your claim might contain a mistake or two, or even a Social Security or policy number that’s just one digit off. If this is the case, the insurance company is quick to deny the claim. Don’t panic until you’re certain you didn’t make any mistakes filing your claim. If you did, fix it and resubmit the claim.
The Problem Was Your Fault
Attorney Matthew L. Sharp states, “Insurance companies owe their customers a duty of good faith and fair dealing, and an insurance company’s violation of this duty can amount to insurance bad faith. In connection with their obligation of good faith and fair dealing, insurance companies have a number of obligations to their customers, including the timely and appropriate payment of claims, compliance with the terms of the insurance policy, and considering policyholders’ interests at least equal to their own interests.”
If your car was broken into, damaged, and in need of repair, it could be pinned on you for leaving shopping bags on the seat. The insurance company is well within its rights to deny a claim for this reason, and it’s devastating for the policyholder. If your medical claim is denied because you forgot to show up for a follow-up appointment, it’s considered lack of due care. Let your attorney help you fight this type of denial.
You Were Not Truthful
Sometimes, you make mistakes when filling out paperwork related to insurance claims. If you were injured at work and required to fill out time-consuming, confusing, and lengthy insurance paperwork, you might accidentally check off the “No” box for one of the health problems you live with. If the insurance company sees this and catches it, they might claim you were not truthful about your medical conditions and deny your claim.
You might not even realize you didn’t fill out the form appropriately. You were in a hurry, you were tired, you were on page 17 of 30 and just looking to finish. Your claim could be denied because you accidentally lied about something.
Call Your Attorney
The best way to handle an insurance claim rejection is to call your attorney. Your attorney can help you go over your policy details to ensure the company didn’t try to deny a claim they can’t deny. Your attorney can help you fix the paperwork you previously submitted by rewording information and clarifying anything that was deemed confusing.
You then resubmit your claim and hope that the insurance company is willing to reconsider their position on their previous denial. Most will, but there are some instances in which a company might continuously deny you in hopes you’ll stop submitting the paperwork for the claim. This is when having an attorney on your side is the most beneficial.
Your attorney’s job is to help you understand the confusing instructions and legal jargon used by insurance companies. The terms they use and ask for aren’t always easily understandable by those who don’t work in the legal or insurance industries, and this makes it very easy for you to make a mistake that might cost you your claim.