Insurance is supposed to give you peace of mind, but when your valid claim gets denied, it can leave you feeling helpless. Sadly, wrongful insurance denials are more common than most people realize. Whether it’s a delayed home repair or a denied medical bill, many individuals find themselves fighting to get what they’re rightfully owed.
So, before you challenge an insurance company, it’s important to understand the tactics they often use to deny valid claims. Keep reading to learn what to watch out for when you’re trying to get your claim paid by your insurance company.
Insurance companies sometimes put profits over people to avoid paying what they owe, and that can delay or completely block your ability to get whatever payout you deserve. When you're dealing with a legitimate claim, these unfair tactics can make the process even more frustrating. To protect yourself, get familiar with these common examples of wrongful insurance denials:
Keep in mind that wrongful denials are just one example of bad faith insurance practices. Even if your claim hasn’t been denied, you may still be dealing with bad faith if your insurance company fails to investigate in a reasonable time, misrepresents your policy, or undervalues your claim.
Facing a wrongful denial of insurance coverage can be overwhelming. It’s even more stressful when you’re counting on that money to recover from an accident, property damage, or medical bills. Still, a denial doesn’t have to be the final word. If your insurer refuses to pay a valid claim, here are some things to do to protect your rights:
1. Keep Detailed Records – Be sure to document every communication you have with your insurer. This includes letters, phone calls, emails, and any correspondence related to your claim. Also, keep track of documentation such as receipts, medical records, and contracts.
2. Talk to a Bad Faith Insurance Attorney – When an insurance company has denied your claim, don’t fight them alone. Getting help from an experienced wrongful insurance claim denial lawyer gives you the legal support needed to take action if your insurer acted in bad faith.
3. Go Over Your Insurance Policy – Before challenging the denial, carefully review your life, health, or auto insurance policy with your lawyer to understand what coverage you're entitled to under the terms of your agreement. This will help you know if the insurer's decision was unjust.
4. Ask for a Clear Explanation – Speak directly with your insurer and request a clear explanation for why your claim was denied. By law, they must provide a valid reason. If their explanation is vague, it could point to insurance bad faith on their part.
5. File an Appeal – You have the option to appeal the decision through your insurance provider’s internal appeals process. This process gives you a chance to challenge the denial and possibly get the outcome changed in your favor.
6. Report the Issue to State Regulators – If you believe your insurer acted in bad faith or your appeal was unfairly denied, you can file a complaint with the Texas Department of Insurance. They may review your case and conduct an investigation into the insurer’s actions. Your lawyer will guide you through every step of the process.
7. Send a Formal Demand Letter – If the Texas Department of Insurance can’t resolve the issue, your lawyer may send a demand letter to your insurer. This letter clearly explains what you're requesting and the reasons why you're entitled to the coverage, stating the intent to sue.
8. Take Legal Action if Needed – If the insurance company refuses to meet your demands, your attorney might advise taking legal action against them through a bad faith claim. In a bad faith case, you may be able to pursue additional compensation beyond what your policy originally covered, such as punitive damages.
9. Consider Alternative Dispute Resolution (ADR) – Sometimes, your lawyer may suggest using mediation or arbitration as an alternative to going to court. These options can often resolve disputes faster and more affordably than a full lawsuit.
When you're facing wrongful insurance denials, it's easy to feel stuck. But by understanding your rights and the common tactics insurers use, you can take steps to protect yourself and seek compensation. At Millin and Millin Attorneys, we stand up for policyholders who’ve been treated unfairly by their insurance companies.
Our team of experienced Texas insurance lawyers is here to explain your legal options and do all they can to fight for the coverage you're owed. If your insurer denied coverage for your valid claim, contact us today for help.
