Insurance policies offer business owners peace of mind that if the unexpected happens, the business will be able to recover and move forward. But what if you file an insurance claim and the insurance company denies it? How do you move forward if you cannot get the reimbursement you need? What options do you have if the insurance company is withholding the very coverage you thought you were paying for? When an insurance company refuses to pay your claim, an experienced Hoffman Estates attorney can help.
Common Reasons for Insurance Claim Denials
Insurance companies will sometimes deny seemingly legitimate claims. Some of the reasons an insurer might deny a claim include:
- Claim was not filed timely
- Incident occurred outside of coverage dates
- Policy exclusions apply
- Policyholder breached a provision of the contract
- Policy does not cover that type of loss
Insurance companies have a duty to act in good faith, which means carefully investigating claims and paying them in a timely manner. If an insurance company denies your claim, it must provide you with a reason. Even if the insurance company believes it is acting in good faith, there may still be grounds for disputing the claim denial. If an insurance company continues to deny your rightful claim, a knowledgeable Hoffman Estates lawyer can help you fight for the coverage to which you are entitled.
Disputing an Insurance Claim Denial
If your insurance claim has been denied, the first thing you should do is to request an explanation in writing and carefully review your insurance policy. It is possible that coverage is not available under the terms of the contract. If the loss or event in question should in fact be covered, you will need to notify the insurance company in writing that you are appealing the claim denial. You will also need to provide a written explanation as to why your claim should be allowed and submit any documentation or additional facts that support your position. A Hoffman Estates attorney can assist you with all aspects of insurance claim disputes — from reviewing your policy to taking the insurance company to court if necessary. Because policy provisions are often open to interpretation, it is important to work with an attorney who specializes in insurance law.
Insurance Bad Faith
Unfortunately, insurance companies do not always act in good faith. The following are examples of insurance bad faith:
- Refusing to pay a claim without conducting a reasonable investigation
- Failing to make a claim determination within a reasonable amount of time
- Failing to provide a reason as to why a claim was denied
- Unreasonably delaying payment of a claim
- Unreasonably undervaluing a claim
- Unjustly raising premiums
- Wrongfully cancelling a policy