Insurance Claims Denied? Fight Back with an Experienced Lawyer
Insurance is not meant to pay a guaranteed, fixed amount back to the insured person; rather, it is a safety contract for those who want to save themselves from uncontrollable monetary hurts. Nonetheless, navigating the filing of a claim can prove to be frustrating from time to time, especially when it comes to denied claims.
In Houston, Texas, insurance claim denials have increased by 27% over the past two years, putting many residents in difficult financial situations. The Texas Department of Insurance reported over 15,000 complaint filings related to denied claims in Houston alone last year. When facing a denied claim, consulting with Lowe Law: The Insurance Outlaw can provide Houston residents with the expertise needed to challenge insurance companies that wrongfully deny legitimate claims.
Why Are Claims Denied in the First Place?
There are many reasons that insurance companies might deny your claim. More often than not, those denied claims result from inadequate documentation. Filling in the wrong details in the initial paperwork can lead to outright rejection. This can be avoided by making sure every needed form is filled flawlessly.
A second reason that this occurs often is that the policy excludes certain things. There are exact terms in an insurance policy that precisely define what coverage entails. Claims that fall outside these limits might be denied. But you can avoid misunderstandings by getting familiar with the particulars of the policy before filing for a claim.
Timeliness is also an important factor. Submitting a claim after the deadline may result in automatic rejection. Either way, the policy requires that the timeliness of events be followed to maintain the viability of claims. According to the Consumer Financial Protection Bureau, approximately 30% of denied insurance claims are due to missed deadlines or incomplete information, making prompt action crucial when filing a claim.
Focus on the Lawyer’s Role in a Claim that is Being Disputed
This is where an experienced lawyer can help with denied claims. They know how to read complicated policy language and notice if something is missing. This lets one know if the rejection is warranted. Attorneys can also help collect other evidence, such as medical records, witness statements, or other relevant documents. Having a claim backed by extensive evidence would make it more likely to succeed.
Also, an attorney can communicate with the insurer on behalf of the policyholder. This can remove some of the friction directly related to negotiations. When you are doing it as a professional, you get an expansive discussion out of it.
What to Do When a Claim Gets Denied
A denial notice can be disappointing, but you have options. Before you even start, the most important step is to read the denial letter closely. Knowing exactly why you were rejected can help guide your next steps. The smartest decision is to check with the insurance company to get detailed information on why the claim was denied, when the denial appears to be questionable. This conversation could expose some simple problems that can be fixed quickly.
If it is still refused, seeking legal counsel is a logical step. They can assess the situation and advise on the proper course of action. Legal advice makes certain that every avenue is pursued.
The Advantages of Having a Lawyer on Your Side
This comes with various benefits of having some kind of legal representation on your side. The lawyer helps to keep the situation objective and makes an informed decision. Their experience dealing with similar cases gives leverage that you might not have considered. They can also handle settlement negotiations. Legal pressure can motivate insurers to settle, which sometimes leads to better terms for the claimant.
Attorneys are also preparing for potential litigation. If negotiations are unsuccessful, the lawyer may be ready to present the complaint at trial, and this may motivate the insurer to think twice.
Choosing the Right Lawyer
Chris Gallo, attorney at Meyer, Suozzi, English & Klein. Insurance claim dispute experience is required. An attorney experienced in this area can provide this knowledge. You should also evaluate their communication style. An attorney who is willing to listen and communicate effectively will make this process much easier. Building a good rapport ensures the client does not feel abandoned during the proceedings.
Finally, it is also advisable to assess their fee structure. This, in turn, allows for an informed decision to be made once the costs involved are understood. Some lawyers operate on a contingency basis, charging fees only if they win the case.
Conclusion
Dealing with an insurance claim denial can be disheartening, but it does not have to be the end of the line. With knowledge of why they may be denied and with the help of a skilled lawyer, they can increase their chance of success. Having legal representation steps you through the claims process so that nothing is missed along the way. By taking precautionary measures and better preparing themselves, people can strike back with confidence when insurance claim denials occur.
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