What to Consider If You are Attempting to Sue an Insurance Company

What to Consider If You are Attempting to Sue an Insurance Company

May 26, 2022

Health Insurance, Life Insurance, Long-Term Disability Insurance, and Auto Insurance are the four basic types of protection that everyone should have, according to Investopedia. Although these are the four most common, there are other insurance options.

In a time of uncertainty, you might rely on your insurance company to help you. Even though insurance is designed to support, many times, insurance firms disregard specific provisions. That is why it is vital to have a knowledgeable insurance attorney defend you when an insurance claim is not followed.

 We have listed several insurance coverages below to help you better understand the various forms of insurance coverage:

  • Health Insurance- In exchange for a premium, a provider offers to pay a percentage of the healthcare expenditures.
  • Life Insurance- In exchange for a premium, the insurer agrees to pay a lump sum to the beneficiary following your death.
  • Auto Insurance- Your insurance provider will compensate you financially in the case of an accident or theft.
  • Home/renters Insurance- Homeowners insurance will protect not only the individual's personal belongings, but also the property's structure. Personal belongings in the property are covered by renter's insurance, but the property itself is not.
  • Long-term Disability-a contract in place to secure your income in the event that you will be unable to perform due to an injury or illness

Frequently Asked Questions

Q: What would my Insurance Attorney help me with?

A: When your claim has already been denied, a skilled attorney can analyze it from all angles to see if the insurance company is willing to reconsider.

Q: When should I pursue a bad faith claim on my insurance company?

A: When a third party sues you and your insurers fail to investigate the matter thoroughly.

Q: How must I engage with claim adjusters?

A: Avoid acknowledging any adjuster charges. Request that all communications be handled through your attorney.

Q: Is it legal for me to sue my insurer?

A: Yes. If an insurance company acts in bad faith, the insurer may be held liable in court.

Why Do Insurance Companies Underpay Claims?

To maximize profits. In doing so, insurance companies may utilize a number of techniques to underpay or deny claims. Some of which we have listed below:

  • Using fictitious depreciation to compute an asset's worth.
  • Whenever natural disasters have struck and building costs have risen, use outdated, inaccurate price lists.
  • Inability to accurately evaluate unusual items.
  • stating that the coverage does not insure this degree of damage
  • Postponing a claim with the hope that the policyholder will become impatient and accept a lower reimbursement.

What Can I Expect?

When suing an insurance company, there are numerous components to consider. Insurance companies will almost certainly deny your claim for a range of factors, some of which are totally legitimate and many of which are not. The following are some of the reasons insurance companies may deny your claim:

  • Inadequate coverage
  • Application flaws
  • Insurance deception
  • Denial in bad faith

What Happens Now That I've Found an Attorney?

After you hire a lawyer, they will begin searching into the facts and history of your conflict with the insurance company's lawyers. They will reveal this information through a procedure known as discovery. Discovery is the formal process of sending and receiving information between parties on the testimony and evidence they will provide at trial. Throughout this procedure, both you and the insurance company will spend legal fees, investigators, discovery, and travel costs. Your attorney will also prepare you for a deposition during the duration of the dispute. When this occurs, you will commit to responding to inquiries honestly. During the deposition, your attorney will raise objections to protect you from unfair questioning. If you do not agree to a settlement and your lawsuit proceeds to court, you will be called to testify in person. Unfortunately, it may take years to resolve a lawsuit. During this procedure, you must be patient, trust your insurance attorney, and wait for the outcome. Your attorney should be able to handle the situation and keep you informed on a regular basis.

What Is the Basis of an Insurance Claim?

When an accident takes place, filing an insurance claim is essentially a request to your insurance provider. When you file a claim, it is usually because your house has been damaged, you have been ill, or an event mentioned in the insurance policy that would typically result in reimbursement has occurred. A claim may be submitted if it results from one of the risks specified in your policy. In the event of a loss or damage, your insurance will protect and compensate you.

Filing Insurance Claims

There are various factors to consider if you are preparing to file an insurance claim due to a hurricane, wildfire, automobile theft, health, or other conditions. Keeping as many good notes as possible is a vital practice. By documenting all procedures, being proactive in your note-taking can allow for a more efficient flow of information. If a problem emerges, the more information you have gathered, the better your litigation attorney will be able to represent you. Attempt to be open and truthful. Your goal is to reclaim assets and property that properly belong to you. Keep in mind that you are up against a for-profit corporation with an attorney and a team on its side. Contact your lawyer if at all feasible before signing anything.

Life Insurance Claim Options

Maturity Claims and Death Claims are the two types of life insurance claims. Maturity claims are those that emerge as the insurance ages. Maturity claims are the simplest because the life insured only needs to fill out a policy discharge form. The maturity money is paid quickly after the insurance discharge paperwork is completed. If the policy discharge form is correctly completed and filed well before the maturity date, the money is normally paid out before the maturity date. Typically, the insurance provider will give you the claim form well in advance of the policy's expiration date. Death Claims are requests for the payment of life insurance benefits.

How Do I Submit a Life Insurance Claim?

According to Ramsey Solutions, there are four main ways to collect your life insurance.

  • You must contact your insurer.
  • Copies of the death certificate must be obtained. Verify that the funeral director has authenticated the copies.
  • You must fill out the relevant paperwork and return it to the insurance company. The majority of these forms can be found online. They may also ask for the death certificate along with the form.
  • You must indicate how you wish to be reimbursed.

When Should I Consult an Attorney?

In general, Life Insurance Claims go off without a hitch. Of course, there will be times when your Life Insurance settlement is a problem. You may put off choosing an attorney as a client for various reasons. Fortunately, an expert attorney, such as an insurance attorney, can assist you in evaluating your policy's terms and determining your legal choices. An attorney will also aid you in gathering evidence to support your claim and, if required, will represent you in court. One of the most common reasons people do not seek help is because they do not know an attorney specializing in this area.

Health Insurance Claims

According to the 2020 census conducted by the The United States Census Bureau, for all or part of 2020, health insurance was available to 91.4 percent of the population. Insurance is essential for both firms and employees, but insurance companies regularly fail to respect specific plans.

Frequently, your doctor will file insurance claims in your favor, this is why most offices require you to show your insurance card when you arrive.When you receive an invoice from your provider, your insurance company will match your coverage to the services provided and reimburse you appropriately. If any portion of your claim is not covered, you must pay the difference, as detailed in the explanation of benefits.

Some health companies require claims to be submitted before they can provide services. Preauthorization is required, and failure to complete it may result in the rejection of any or all of your claims. Before performing any major medical procedure or incurring any costs, check with your insurance company to determine if prior permission is necessary.

What Should You Know Before Filing a Bad Faith Claim Against a Health Insurance Company?

Health insurance companies can engage in a number of bad faith actions that either directly or implicitly violate a good-faith assurance. Examples of insurers acting in bad faith include:

  • Purposefully misconstrued the policy.
  • Failure to contact policyholders about a claim.
  • Attempting to stall an investigation with no explanation.
  • Stall techniques such as limiting communication or imposing burdensome documentation and verification requirements.
  • Delaying payment on a valid claim.
  • Before purchasing an insurance policy, people are misinformed.
  • Confusion between a treatment and experimental, cosmetic, or elective surgery.

To sue an insurer in court for damages based on bad faith. One of the criteria is to include in your complaint what the insurance provider did or did not do to demonstrate good faith. You must show that the insurance company acted in bad faith when processing your claim and maintaining the provisions of your policy. You must describe how the insurance company's actions cost you money.

What is Long-Term Disability? 

Long-term disability insurance protects your income in the event that you are unable to work due to illness or an accident. Long-term disability is not confined to damaged persons, as many people assume. Long-term disability can also refer to a variety of medical disorders, including but not limited to the following:

  • Bipolar disorder
  • Cancer 
  • Chronic fatigue syndrome 
  • Crohn’s disease 
  • Degenerative disc disease

How Can I Obtain Help With My Long-Term Disability claim?

Our Long Term Disability Lawyers have assisted countless customers with a range of claims. We can help you in filling out claim forms, reviewing your medical records, and recommending any extra doctor's visits or screening examinations that may support your claim. Counseling is also advised to prevent the dangers that insurance companies may use to refuse coverage. If your claim is denied, demonstrating your eligibility and submitting an administrative disability appeal as soon as possible would be beneficial. Your long-term disability attorney will advise you to compile evidence and obtain expert witness testimony.

Auto Insurance

When purchasing or leasing a car, one must safeguard their investment. If your car is damaged in an accident, theft, vandalism, or natural disaster, purchasing auto insurance may provide you with peace of mind. Rather of paying for auto accidents out of pocket, people make annual payments to an auto insurance company; the company then pays all or most of the costs connected with an auto accident or other vehicle damage.

After an Accident, Who Can I Sue?

You may be thinking, "Who do I sue after an automobile accident?" after seeking medical help and filing all essential documentation at the accident site.

Many injured drivers simply submit a claim with the other party's insurance company. On the other hand, car accidents may lead to a lawsuit, especially if the insurance company refuses to pay you the total amount you are entitled to. If the at-fault motorist does not have insurance, you have two choices:

  • You have the option of suing the motorist personally. Remember that uninsured drivers may not have many assets to draw upon to pay for a lawsuit. As a result, even if you win your case against the driver, you may not be able to recover.
  • File an uninsured motorist claim to your own insurance company if you have it. Keep in mind that the value of your uninsured motorist benefits cannot exceed the benefits of your actual policy.

Homeowners/Renter’s Claims

Owning property may mean coping with the unpredictable, which might range from a tree falling on your roof to a pipe bursting in your bathroom. Natural disasters are one of the most challenging difficulties a homeowner faces. According to the Department of Homeland Security, natural disasters include "all types of extreme weather that have the potential to inflict substantial harm to human health and safety, property, critical infrastructure, and homeland security."

These tragedies can strike abruptly or on a regular basis, causing Americans to experience repeating periods of economic loss, instability, and discomfort. Tornadoes, flooding, winter storms, wildfires, and earthquakes are examples of natural disasters. Although many individuals anticipate insurance providers to repair any natural disaster damage as soon as they make a claim, this is not always the case. If the insurance provider determines that the damage occurred prior to the event, policyholders may be refused coverage.


Works Cited

4 Types of Insurance Policies Everyone Needs. (n.d.). Investopedia. https://www.investopedia.com/financial-edge/0212/4-types-of-insurance-everyone-needs.aspx

How to File a Life Insurance Claim. (2021, December 30). Ramsey Solutions. https://www.ramseysolutions.com/insurance/life-insurance-claims

Keisler, K., & Bunch, L. N. (2021, September 14). Health Insurance Coverage in the United States: 2020. Census Bureau. https://www.census.gov/library/publications/2021/demo/p60-274.html

Natural Disasters. (2021, December 17). Homeland Security. https://www.dhs.gov/natural-disasters

Silberstein, S. (n.d.). What Is an Insurance Claim? The Balance. https://www.thebalance.com/understanding-insurance-claims-2645921

How Courts Work. (2021, November 28). How Courts Work. https://www.americanbar.org/groups/public_education/resources/law_related_education_network/how_courts_work/discovery/

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