Texas Insurance Claim Attorneys

In an ideal world, you would file a claim with your insurance provider. Your adjuster would provide you with a claim number and begin investigating your case within 2 weeks of filing. After a thorough investigation, your adjuster will return to you within 30 days and either accept your claim or deny it. If you need to file a claim with another person’s insurance company, the process would be the same—only it would be prudent to conduct your own investigation and provide as much subjective evidence as possible. Once the evidence is gathered, you’ll file a formal demand letter with the at-fault party’s insurance company and work out a settlement. If they refuse to offer fair compensation, you can take them to court. Having an attorney at your side for this entire process makes it smoother and increases the likelihood that it will end in your favor.

Insurance claims can be denied for legitimate legal reasons: coverage doesn’t extend to the injury or damage, the injured person was not covered at the time, or the cause of the injury voided the policy. However, sometimes providers commit “insurance bad faith”—the denial of coverage for unclear or illegitimate reasons. This may occur as a result of poor or fraudulent practices. For example, if your valid claim would result in a massive payout, then an unscrupulous provider would be motivated to deny it outright.

To help prevent bad faith, the law forces insurance companies to respond to your claim within 2 weeks of filing. They are also obligated to provide a clear reason for why your claim was denied. If your insurance provider did not offer a reason for why your claim was denied or delayed, you may be entitled to an insurance bad faith claim. For injury cases, insurers need to respect your medical privacy. Your claims adjuster is entitled to view the medical records relevant to your current claim, but no more than that. To get around that, some insurance companies will ask you to waive your right to keep your records private. The adjuster will note that your records are required for investigation…but may fail to mention that they only require a few documents, not your entire medical history. Experienced attorneys can ensure that your adjuster only has access to relevant documents and nothing else.

They are not allowed to delay payment unreasonably under any circumstances. Sometimes insurance companies will demand documents or interviews as a way of delaying the need to pay you—this is both illegal and unethical. Companies may also delay investigating your claim, which is equally illegal. In both of these cases, you’re being subjected to pressure tactics. By delaying payment, insurance companies hope to either make people give up on their claims or settle for a lower amount. Navigating the insurance minefield requires experience, but it can be done. You can take legal action against this type of treatment.