The main purpose of insurance is to relieve you of the financial strain that comes with illness and injury. If you have been hurt and you submit a claim to cover your medical expenses, it is reasonable for you to expect the insurance company to act in accordance with your policy. Unfortunately, things do not always play out this way. The trouble is that insurance companies are mostly concerned with their financial interests, not yours. And the company with which you have a policy may deny your claim for any number of reasons.
The Insurance Claims Process and Reasons for Denial
The basics of the insurance claims process is as follows:
1. You are injured and you file a claim with your insurance provider
2. The company assigns an adjuster to your case who will investigate your claim and decide whether to approve or deny it
3. If the company approves the claim, you will work with the adjuster to determine how much money you are to receive
4. If the company denies your claim, you should seek legal counsel
Some of the reasons why insurance providers deny claims include:
- The damage or injury you sustained was not covered by the policy
- The accident was not reported on time
- The damage or injury isn’t properly or sufficiently documented
- Your behavior led to the damage or injury
- The company believes you made a false claim
While an insurance company has a right to contest claims that it finds suspicious it cannot make up bogus reasons to deny your claim. Insurance companies must act fairly and honestly in dealing with you and handling your claim. Otherwise, they will be acting in bad faith and can be sued.
If your insurance claim was denied, you do have recourse. North Miami Florida attorneys specialize in helping people take on insurance companies that treat them unjustly. Miami Fl attorneys hold insurance companies that act in bad faith accountable. You should call the attorneys in North Miami FL at Buchalter Hoffman and Dorchak for a consultation.