When you have insurance, you rely on it and expect it to fulfill its liability for what you pay. Unfortunately, that doesn’t always happen. Most people will need an insurance claim attorney because insurance companies often deny claims.
Here, we will teach you how insurance companies play their cards to give less of what the policyholder expects by applying tactics and techniques that an average person may find reasonable but that put them in an uncomfortable position.
You will know why an attorney for car insurance claims from The Ward Law Group can help you if you or a family member gets in this annoying situation where they can face financial burden even though they were supposedly backed up by a policy they paid.
What is Bad Faith?
Bad faith occurs when a policyholder wants to start a claim process with their insurance company but is unfairly treated, which leads to the claim being denied.
Denies a claim
The insurance company denies a valid claim without proper investigation or valid reasons. For example, it may deny a claim for water damage caused by a burst pipe, stating that it is not covered when the policy includes coverage for water damage, or deny a claim for hail damage to a roof, saying that the policy does not cover “acts of nature.”
It is encouraged for a policyholder to read all the clauses since they may add these lines where they don’t cover something, which is a possibility in your case.
Requires the insured to provide unreasonable information
This happens because they know that not all people save such documents as detailed receipts for every item in a home burglary claim, including items purchased years ago, making it difficult for the insured to provide the requested information or demand irrelevant medical records for a property damage claim.
Repeatedly asks for information, prolonging the claims procedure needlessly.
Multiple communications requesting the same information repeatedly may delay the unnecessary process. This could include requesting multiple copies of documents that have already been provided.
Fails to submit a fair settlement proposal within a reasonable time once liability has become evident
This usually happens after a car accident in which the insured party is not at fault; the insurer fails to make a settlement offer for an extended period. Also, there have been cases of slip-and-fall accidents at a business establishment in which liability is clear, and the insurance company delays making a settlement offer for an extended period, causing financial hardship to the injured party.
Forces an insured to file a lawsuit to recover money owed under an insurance policy
The insurer refuses to pay a legitimate claim for property damage caused by a severe storm, forcing the insured to file a lawsuit to receive the rightful compensation.
Fails to confirm or reject a claim promptly
The insurance company does not provide a response or decision on a claim within a reasonable timeframe. This leaves the insured uncertain and without resolution for an extended period, causing unnecessary stress and financial strain.
For all of the potential actions they may do, you will need an experienced insurance claim attorney to help you fight against these companies that put profits over policyholders.
Why was my insurance claim denied?
There are many reasons why your insurance claim may have been denied. Insurance companies will use one of the following reasons as an excuse to either pay you less amount or refuse to pay for your losses.
Lack of Coverage:
They love to say this to policyholders: “Sorry, but it seems that your plan does not cover the situation you are dealing with; you are on your own.” It's crucial to "it's the policy and understand the coverage limits, exclusions, and conditions. This task may be difficult, but an experienced insurance claim attorney can do it for you.
Policy Exclusions:
Certain events or circumstances may be specifically excluded from coverage. For example, a homeowner's insurance may exclude coverage for damage caused by floods or earthquakes.
Failure to Meet Policy Requirements:
The claim may be denied if the policyholder fails to meet specific policy requirements, such as timely reporting the claim, providing necessary documentation, or fulfilling policy conditions.
This is why it is sometimes used as a bad-faith action. They may ask you for documents that are not relevant or that they know you may not have, and they don’t tell you that they might need them when you file a claim.
Pre-existing Conditions:
In health or life insurance policies, claims related to pre-existing conditions that were not disclosed or covered under the policy may be denied.
For instance, a health insurance claim related to diabetes treatment or complications may be scrutinized if it was a pre-existing condition at the time of policy issuance, or if a policyholder has a pre-existing heart condition and files a claim for cardiac treatment, the insurance company may assess the claim in light of the pre-existing condition.
Regarding life insurance, if a policyholder has a pre-existing terminal illness at the time of policy purchase, the insurer may deny a claim made due to the illness. Also, life insurance claims related to chronic conditions such as advanced-stage kidney disease or chronic obstructive pulmonary disease (COPD) may be affected if they pre-exist at the time of policy issuance.
Misrepresentation or Fraud:
If the policyholder provides false or misleading information during the application process or when filing a claim, the insurance company may deny the claim based on misrepresentation or fraud.
Of course, they have many people working with them who will ensure that all the information they receive is accurate and valid.
Failure to Pay Premiums:
If the policyholder fails to pay premiums within the specified grace period, the insurance company may deny the claim due to the lapse in coverage. They state this very clearly at the beginning.
Sometimes, there is miscommunication between the companies and insured people. Still, you won't receive the coverage if they don’t receive the payment.
Intdidn'tal or Criminal Acts:
Insurance policies typically exclude coverage for intentional or criminal acts the policyholder commits, such as arson or fraud. In this case, they are right not to provide coverage, but a full investigation is needed to reach that verdict. They can’t just assume that it is for the insurance money.
Types of Insurance Claims We Handle
Indeed, many types of insurance are out there, and most of them are needed. If you want to drive a motor vehicle, you must have the required insurance.
If you want to have your integrity saved when you work on a construction site or in a job that is prone to suffer an accident that may lead you to serious injuries or even death, you may need insurance.
The Ward Law Group is here to help you with the following insurance claims.
New York Consumer Protection Laws
A set of laws and regulations designed to protect consumers from unfair and deceptive practices in the marketplace exists. In New York, the Consumer Protection Law encompasses various statutes and regulations to safeguard consumers' rights and fair business practices.
The primary goal of the Consumer Protection Law is to ensure that consumers are treated fairly and are provided with accurate information, quality products, and reliable services. It covers various industries and business transactions, including retail sales, advertising, telemarketing, and debt collection.
The Consumer Protection Law in New York includes provisions that address:
- False Advertising: Prohibiting deceptive or misleading advertising practices, such as false claims, bait-and-switch tactics, or deceptive pricing.
- Unfair Trade Practices: Prohibiting unfair and deceptive practices in business transactions, including fraud, misrepresentation, or any act that can mislead or harm consumers.
- Product Safety: Establishing safety standards for various consumer products and holding manufacturers and sellers accountable for providing safe products.
- Consumer Contracts: Regulating the terms and conditions of consumer contracts, ensuring that they are fair, transparent, and do not contain unfair provisions that disadvantage consumers.
- Consumer Remedies: Providing avenues for consumers to seek legal remedies, such as the right to file complaints, pursue legal action, or seek compensation for damages caused by unfair or deceptive practices.
An experienced and wise insurance claims attorney will use the consumer protection law on your side to fight any of these companies trying to save money and not giving you the compensation they promise and that you paid for with effort for many years.
Contact an Insurance Claim Lawyer Today
At The Ward Law Group, our insurance claim attorneys have been dealing with companies their entire careers. With over 25 years of experience, they understand business like the palm of their hand.
Many people, including minorities, are vulnerable to these massive companies that use their resources to make policyholders believe they won’t be able to receive compensation. If you are dealing with an unfair situation, contact an insurance claim lawyer at 855-DOLOR-55. One of our team lawyers will answer any question you may have entirely for free.