After an accident on the roads or at work, most people rely on their insurance companies to pay for medical expenses or property damage. These times can be trying and emotional enough, but if your insurance company denies your claim, things can can very difficult. Many people think they may not have any recourse once their insurance claim is turned down,  but an attorney can help you to pursue the issue.

In general, you can sue your insurance company if they violate the terms of your insurance policy. This may include not paying claims in a timely manner, refusing to pay insurance claims which were properly filed,  or making bad faith claims. There are laws in place to protect consumers, so if you believe that you were genuinely defrauded, a lawsuit may be your only option.

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Valid Reasons an Insurance Claim May Be Denied

There are legitimate reasons for your insurance company to deny your insurance claim. These may include:

  • Your policy doesn’t cover your situation.  Read the exclusion section of your policy to understand what is not covered, and ask an attorney about any ambiguities.
  • You misrepresented your situation on your application. If the insurer can prove you lied on the application, the policy may be nullified.
  • You didn’t follow insurance claim protocols. From missing a deadline to not including pertinent documents, you can be turned down for an incomplete or erroneous claim application.
  • Your claim was false. Committing insurance fraud is a serious offense which could result in civil and criminal charges.

When Is it Appropriate to Sue? 

Of course, there may be times when your insurance company simply doesn’t want to pay out on your claim or is trying to limit their liability in a large scale situation. However, every insurer has obligations to its policyholders it must uphold. If they do not honor  the terms of the policy – which is a contract – or are acting in bad faith, they need to be held accountable. Some common activities which may justify legal action include:

  • Delaying investigation into your claim for an unreasonable amount of time
  • Not adequately investigating your claim
  • Refusing to pay a reasonable and clear claim
  • Failing to approve or deny a claim within the specified period to do so
  • Denying a claim with no explanation

However, even if you can’t get a satisfactory resolution regarding your insurance claim, you may not have to take them to court. Contact a personal injury or car accident attorney, and they will review your claim, your evidence, and your situation. They are also familiar with local laws and statutes.

Because a professional attorney will have depth of experience  dealing with insurance companies, they may be able to negotiate a deal which is fair to you. The fact is, insurance companies know that if they are obligated to pay the claim, once a lawyer is involved they will be better off paying than going to court.

To File an Insurance Claim

  • Keep documentation of all insurance company correspondence. This includes emails and notes from phone conversations.
  • Realize that your calls are likely recorded, so be honest.
  • Maintain records of all property insured under your policy. Photos are great at telling the story of property damage, especially if you have photos before and after the incident. Thus have a photo inventory is good practice
  • Keep accurate records of medical bills, repairs, attorney’s fees, and lost wages.
  • Hire a Sarasota attorney with success and  experience in insurance litigation.

If you find yourself in an insurance dispute, call an attorney from Probinsky & Cole. We are here to help.

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