How Law Firms Help Clients File an Insurance Claim
May 25th, 2021
By Hayhurst Law
When an insurance company refuses to pay, you may need the help of an attorney.
- Insurance companies deny claims for many reasons, or sometimes, no reason at all.
- An attorney can help you review your case and make a realistic assessment of possible outcomes.
In a perfect world, insurance premiums are paid on time, and when you need to make a claim, the insurance pays out a fair and reasonable settlement to cover your damages. Unfortunately, that’s not always the way insurance claim filings proceed. Often, the insurance company refuses to pay or will only pay a low amount that doesn’t come close to covering your losses. If that happens to you, it may be time to consult an attorney. Here are a few things to know as you prepare for the fight with the insurance company.
Why Do Insurance Claims Get Denied?
Sometimes, insurance companies don’t give a good reason, or any reason at all, when they deny a claim. However, the bottom line is that insurance is a business, and the companies’ profits go up when they can avoid paying out in claims. Here are some of the most common denials consumers receive:
- This policy does not cover your losses. When you get this explanation, it means that the insurance company thinks that your policy doesn’t pay for the kind of damages you are claiming. For example, if a hurricane floods your house, your insurance company may deny the damages by saying you don’t have flood insurance
- You are claiming too much in losses. The insurance company believes that the value you placed on your injuries and damages is too much. Suppose you are in a car accident and your car needs repair. You submit a quote from a repair shop to get it fixed. The insurance company could refuse to pay if they believe the quote is too high.
- You didn’t have any losses related to this claim. The insurance company might think your claim is false or that your losses are related to something other than the incident in your claim. Again, suppose you are in a car accident and you hurt your back. The insurance company might say that the injuries are pre-existing or not as bad as you claim.
What Information Will I Need to Fight Back?
Your case begins with your documentation. What you need varies some according to the type of claim you’re filing, but here are some things you’ll need to fight back in insurance disputes:
- Your attorney will want to review your insurance policy documents. If you don’t have them, you can request a copy from your insurance agent or the company directly. Some companies make the records available online.
- Bring to the meeting any documents related to the status of your claim. If you have letters from the insurance company denying your claim or refusing to pay the amount you expected, those are especially important.
- Your lawyer will need copies of any claims paperwork and supporting documentation you already submitted to the insurance company. For example, if your claim involves medical records, you will need to get copies of those from your healthcare providers.
How Can an Attorney Help?
An attorney can analyze your policy and your claim to give you advice on how you might proceed, how long the legal process could take, and how much you might be able to recover. Then, if you proceed to a lawsuit, the lawyer can file it, handle any negotiations that take place afterward, and represent you in court, if necessary. Hayhurst Law has the experience that you need to pursue insurance claims in Pennsylvania and West Virginia. Contact us today to get started.
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