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What Can You Do If An Insurance Claim Is Denied?

If you just found out that an insurance claim has been denied, and you are convinced that the claim should have been approved, no doubt you're infuriated and trying to find out what to do. Your first instinct may be to look for a lawyer, and while it's a good idea to start researching names now in case you need them, there are other steps you should take in the meantime. Sometimes these steps resolve the problem without having to resort to legal means. Other times, the steps simply form a very good paper trail that can help you if your case goes to court.

Know What Your Policy Covers

Unfortunately, a lot of insurance claim denials are based on misinterpretations of the policy that's in place. Be very sure you know what your policy covers, and get in writing the details surrounding the denial. It's not good enough for the insurance company to say something wasn't covered or that the insurance company decided the event was your fault due to some ridiculous issue (for example, damage to a storage shed on your property from a neighbor's tree brushed off as your fault for placing the storage shed in that spot). But if you know that your policy covers the claim, and you can point out the exact clauses that support your case, then you could get more positive action going.

Escalate It

Most of the time, you're dealing with a local agent or customer service office for the insurance company. If you have to, start going up the chain of command. Talk to regional offices and national agency representatives. Always keep records, and always have the exact policy pages that you need in front of you.

State Agencies

Sometimes a complaint to a state agency, such as an insurance commissioner or attorney general's office, can right the wrong. These agencies oversee consumer protections for insurance and other businesses, and if the insurance company knows that now they're on the agency's radar, you might see more positive action taken on your claim, especially if there is a clear breach of policy behind the denial.

If all that hasn't worked, or if the company in question is now giving you an even harder time and threatening to do things like drop your policy, then you need a lawyer. Don't go with just any lawyer; you'll need one skilled in fighting insurance claim denials. Check out a law firm like Bidegaray Law Firm LLP to find lawyers like this. Don't give up the fight if you know you're right.