What to Do if Insurance Companies Don't Pay Claims

You have paid your insurance coverage premiums for years without a claim. Now you have a claim, and are confident the insurance company will pay you the value of your claim immediately. The insurance company agent assured you that the policy fully covered you when you purchased it.

Reality versus your assumptions is about to set in. You have reported your claim and have provided all the requested details to your insurer. You wait patiently for confirmation of coverage. Sadly, you may be more likely to receive a letter denying your claim than a check.

Many of the insurance giants instituted a policy of denying claims in an effort to become more profitable. To encourage adjusters to find creative reasons to deny valid claims, some insurance companies started an incentive program where employees were rewarded for finding reasons to deny a claim. Common reasons for denial include paperwork errors and expiration of time periods for submission of documents.

Insurance companies have two major reasons to delay payment of claims. The first is, if the settlement is delayed long enough, there is a chance the policyholder may die before payment is made. If the policyholder dies, the process for collecting the funds becomes more difficult. The second reason is the longer the insurer delays in making payment, the more time the insurance company has to hold onto premiums and earn money on their investments. Not only do insurance companies delay payments, they also attempt to delay court proceedings. The insurer hopes the net result will be you give up because of the stress in continuing the fight or settle your claim for less than full value.

The final component of this strategy, defend, often begins with a low-ball offer. Some insurance companies have presented offers as low as $50 to claimants. Insurance companies have developed effective protocols for dealing with specific claims through experience and case law.

There are certain ways of protecting your claim:

– Read your policy thoroughly and be sure you understand what you are entitled to receive;

– Involve a lawyer as soon as practicable;

– Fill out forms carefully. A honest mistake can be used by the insurance company to deny your claim;

– Write letters or send emails rather than make phone calls to the insurer. Everything you say needs to be on paper as proof if you have to fight for your settlement;

– If the insurance company sends you a check for premium refunds because they are canceling your insurance, do NOT cash the check. If you do, this may be seen as agreement with the insurer’s decision;

– Do not give up. Perseverance may win the day even if it takes a long time.

– Involve your Insurance Commissioner’s office if the problem warrants it.

If your insurance company is utilizing the “deny, delay and defend” strategy against you, it is strongly recommended you contact an experienced insurance attorney to protect your rights. Contact us today and we can answer any questions you may have. Toll free 888-244-5480 or www.hcwlaw.com