What Could a Denied Claim Mean?
While insurance companies claim to exist to serve their customers, they are ultimately businesses—not charities. Like any business, their existence depends on receiving more money than they disburse, so adjusters are instructed to be extremely particular about which insurance claims they honor. To balance out this tension between profitability and policy fulfillment, insurance companies are legally bound to “act in good faith” with you. That means any claim must be acknowledged and start the investigation process within 15 days of filing.
On the 15th day, you must receive notice of rejection or acceptance. Finally, rejected claims are legally required to come with an explanation. If you have had your claim rejected, you should have received your notice of the reason why. While it may feel unfair (and many times it often is), there are plenty of legal reasons why your insurance company may have denied your claim.
If your claim was rejected on the following grounds, your options might be limited, though you may be able to file an appeal. However, if you feel that your claim was still rejected unjustly, give us a call. We are more than happy to help you.
If Your Claim Was Filed Late...
One of those reasons may be that you did not file your claim on time. Time limits will differ for different claims. An auto insurance claim will differ from a workers' compensation claim, and so on. It is always best to file your claim as soon as possible after an accident or other damages. If you are unsure how long you have to file, contact your insurance company to find out. A denied claim may simply mean you did not file within the time limits. There may be exceptions that grant you some flexibility, but it is better not to take a chance when you have been injured.
If Your Claim Was Not Valid...
This is not the same as lacking a valid reason for seeking recovery. Your injuries are valid and are still perhaps entitled to compensation. However, insurance adjusters will find myriad reasons for why they are not obligated to fulfill a policy. For example, if you are attempting to file a workers' compensation claim because of a work accident, your claim may be denied because your injuries did not take place in relation to performing your job duties—no matter how severe your damages. In some cases, people are denied support because the insurance company believes your injuries were caused in an earlier incident or are not related to the accident you are claiming. For instance, if you file a claim for the damage a car accident caused to your knee, the adjuster may claim that knee surgery years earlier is the cause. One related denial justification is that you lack the necessary documents to justify a claim—a perfect illustration of why filing with an injury lawyer could help speed up your process.
If Your Monthly Premiums Are Unpaid...
Insurance companies are only obligated to honor the contracts that do not lapse. Adjusters may deny your claim if they do not have a record of payments. This is why it is important to keep all receipts on file, so you can easily prove that you made a payment if it is called into question.
How a Texas Insurance Claim Lawyer Can Help
Insurance lawyers know the insurance company's tactics, their loopholes, and what makes them nervous. If you have been hurt by another’s negligence, an injury lawyer can do more than prepare your case for court—they can represent you while dealing with your insurance adjuster. For instance, we can ensure that your insurance company only has access to your relevant medical records, not your entire medical history. We can make sure there no loopholes on your end regarding your claim, and we can fight for the settlement you deserve.
Having a trial lawyer on your side also provides leverage. The insurance company knows that if they walk away from your settlement offer, they are facing the possibility of costly litigation. It makes them that much more willing to pay the amount you are entitled to. With severe injuries, illness, disability, and property damage, facing a denied claim can be both terrifying and frustrating. No one wants to feel like he or she are free falling without a safety net. However, if your claim was denied, you can still have a lawyer determine if legal action would help.
Houston Insurance Attorneys for Denied Insurance Claims in Texas
What drives our insurance denial law firm is knowing that there are people who are being wrongfully denied coverage from their insurance companies. These bad faith practices should not be tolerated, which is why we want to speak with you if this has happened. In the wake of natural disasters, your insurance policy may seem like your only hope. This is why, when it is pulled out from under you, you may be left feeling hopeless.
At Arnold & Itkin, we are passionate about protecting the rights of faithful policyholders whose insurance claims have been denied. Don't get left having to pay for something that should be taken care of by your insurance company. Get in touch with our law firm to find out how we can help you.
Contact a Texas insurance claim denial attorney from Arnold & Itkin today! Call (888) 493-1629.
