No company wants to pay money if they can avoid it. So, it is not uncommon for insurance companies to deny claims. I say fight, fight, fight. In some ways, you are fortunate since, in Arkansas, insurance companies have specific legal obligations when processing claims.
Here are 6 things you need to know:
To deny your claim, the insurance company can say it is not covered under your policy. This denial is usually for one of two reasons. It excludes pre-existing conditions or specific policy exclusions. We have years of experience reading insurance policies and can generally tell you what is and is not covered. Don’t accept a denial without fighting back. Some insurance companies seem to deny the claim for any reason in the hopes that you will go away.
This paperwork excuse is all too common. The insurance company will say you did not provide everything, and therefore, it will pay you nothing. Keep pushing back. Watch out for any time frame restriction. If you file outside that window, getting your money can be real trouble. For example, Medicare gives you only 60 days to contact them about an appeal.
You have a legal right to appeal. Here is where you may want to get a lawyer involved. You should be sent instructions on how to appeal with your denial letter. However, if they are going to play hardball, it has been my experience that you need to show you are seriously pursuing this. Having a lawyer does that.
If your insurance claim is denied, you may be responsible for paying the costs of any medical treatment or repairs out-of-pocket. However, there are government and charity programs that can help you. For example, social security disability can be a way to get money if you cannot work.
The law requires insurance companies to act in good faith when handling claims. However, some insurers may employ bad faith tactics. Examples include denying a claim without conducting a proper investigation, delaying the payment of benefits unreasonably, making false statements about coverage, asking for unreasonable proof of loss, and offering an unreasonably low settlement.
When filing an insurance claim, having the right professional on your side can make a big difference. Fighting against insurance companies is what we do. We know the tricks and how to get around them. Many clients need to focus on getting better or getting their property fixed – not fighting a massive machine that seems to care little for them. Remember you are not dealing with Flo, Jake, or The General; you are facing a team of highly trained professionals that are rewarded for getting you to accept the absolute minimum.
We understand the complexities of filing and appealing an insurance claim at Horton Law. With years of experience helping clients get fair and just results from their insurers, we can provide the professional advice and legal services you need. Give us a call today.
If you have any questions, we’ll help you find answers. Let our experience protect your rights to the full and fair compensation you deserve. Call Horton Personal Injury Lawyers for a Free Legal Consultation at 888-822-6011 or fill out a Free Consultation Form.