Insurance Claims in Hawaii

We're sure you've heard the term "protecting your rights" from lawyer advertisements, but what does that actually mean? Protecting rights from a personal injury perspective means ensuring a person's rights in a legal dispute are not ignored or infringed upon. Our insurance attorneys help from accident or damage reconstruction to skillful negotiations to ensure our clients get what is rightfully owed to them. We also make sure they don't pay any more than they need to in a counterclaim. 

You're probably familiar with the term "getting the compensation you deserve" as well from lawyer advertisements. We mean that. Suppose you signed an insurance contract in good faith and paid your premiums faithfully. In that case, you should receive the financial protection outlined in the agreement. Likewise, if you were harmed through someone else's negligence, you have a right to be compensated for your losses. That's how insurance attorneys help clients. Our insurance attorneys practice insurance law and can assist in providing legal advice, negotiating on your behalf, and representing you in court. 

You need an insurance attorney when you need legal advice about any insurance claim. All cases are unique, but some reasons why people need legal help include the following:

• You need to sue an insurance company about a contract-related issue
• You need help determining a fair settlement amount in a personal injury claim
• You need to force compliance against an insurance company in civil court
• You need help proving a claim was denied in bad faith

It's not always necessary to file a personal injury lawsuit to recover compensation after an accident. In almost every instance, the first step is to file a claim with an insurer. Here are the typical steps in the insurance claim process:

Gather information for your claim - The validity of claims is established by gathering the relevant information and presenting it to an insurance company. For example, in the event of a car accident, you'll need the other driver's information, the location, time, date of the accident, and the injuries and property damage you sustained, along with other expenses.

File the insurance claim - Filing claims in a prompt manner is always advisable. Depending on the type of claim, some insurance companies have limited the amount of time you have to contact them after the incident that prompts the claim. The purpose of filing a claim is to inform the insurance company that you intend to pursue damages. 

Once the claim is filed, the next step is to wait for them to respond. Except in the event of a natural disaster, you should expect a prompt reply, usually from an insurance adjuster. In Hawaii, insurance companies have 15 days. You may get a "reservation of rights" (ROR) letter which is an acknowledgment of receipt and that the adjuster will commence an investigation. The ROR letter is the insurance company's notification that they are not yet accepting liability or fault. Hawaiian insurance companies have 45 days to settle a claim and make a payment once the claim is filed.

Layout your damages and demand compensation - After reviewing the ROR letter, you can submit a demand letter. Still, when to submit the letter will depend on what type of insurance claim you have. If you were injured, you should wait until you're significantly recovered because you won't know your true costs until then. In the event of serious injury, it's crucial to get the help of an attorney to help with the projection of costs. We may need to involve medical experts that are familiar with your type of injury to make this forecast. 

Demand letters should present evidence that supports your side of the argument and includes an ask for explicit compensation. Details are crucial. Provide itemized lists for all medical expenses, property damage, lost wages, disability, and any other losses related to the incident. These expenses are known as "economic" damages. Once economic damages have been tallied, you can calculate your noneconomic losses (usually pain and suffering or mental anguish.) Coming up with a number can be a challenge since these losses are unquantifiable. Still, most multiply their economic losses between 2 and 5 depending on the severity of the injuries to come up with a number. 

Review your first settlement offer - Once an insurance company receives a demand letter, it must respond. Any significant delay may mean the insurance adjuster is still investigating. However, some insurance companies have been known to use delay tactics to measure your patience. Delaying payment can make some people panic about bills piling up, so they'll be happy to accept whatever the insurance company offers. 

Your first settlement offer may be laughable low with excuses like you've asked too much for your injuries or you haven't provided sufficient proof of expenses and losses. Many first offers won't cover the extent of your losses. Don't give in to pressure tactics. There is no first and final offer when it comes to insurance. Be aware that if you accept a settlement offer, you'll be required to sign a waiver, which means the money you take is the last you'll see from them, despite anything they say otherwise. It's a binding agreement giving up your legal option to recover any more compensation on the claim.  

Make a counteroffer - You have a right to reject a settlement offer by presenting a counteroffer. You can come back with your first demand or negotiate somewhere in the middle. Negotiations are where Morgan and Morgan's attorneys shine. This is how most insurance disputes are settled. A counteroffer should accentuate suffering and losses and outline that you are serious about recovering accurate compensation. 
 

If you've made it this far without an attorney, that's fantastic. However, if the insurance company responds to your counteroffer with bad news, it's time to get professional help. Unfortunately, even when you're negotiating in good faith as a private individual, it sometimes takes the threat of legal action to get them to come to the table. You don't have to accept an insurance settlement because they're trying to make you feel grateful for something rather than nothing. 

Morgan and Morgan's attorneys have the skills, experience, and expertise to negotiate a fair settlement. Working with our insurance attorneys in Hawaii can significantly increase your chances of recovering the maximum compensation possible up to the term limits. If another party is responsible for your injuries and property damage, insurance doesn't have to be the end of it either. Negligent parties may have other assets to pursue beyond insurance. If you were injured in an auto accident, Hawaii's no-fault insurance law allows you to pursue at-fault parties when injuries sustained exceed personal injury protection (PIP) policy limits.

When your home insurance claim is denied, the company will send you a formal notice with the reason for the denial. This will typically point out the language in your policy that justifies their decision. Some denials are legitimate such as a lapse in premium payments, or the loss isn't included in the policy. You can start with a conversation, but usually, you'll need to file an appeal. Be aware there are deadlines and formal processes for doing so. Any appeal should contain new information and evidence as to why the decision should be reversed. Ideally, you'll have the help of one of the lawyers to ensure your appeal is successful.

Denial of a health insurance claim is incredibly upsetting. Very little on this earth is of higher value than our health. When our doctor prescribes a medication or recommends medical treatment, their medical opinion should be regarded more highly than an insurance adjuster. You may be denied because they deem care is not medically necessary, it wasn't authorized, the treatment is experimental, or the provider is out-of-network. 

Most health care insurance makes you exhaust their appeals process before pursuing a lawsuit. However, appeals have deadlines that are linked to your ability to pursue legal action, so be very mindful of this. Our lawyers can take over at any time during the appeals process or when you're ready to file a lawsuit. When it comes to your healthcare, time is of the essence, and we can increase your chances of having your claim approved.

As Hawaii is a no-fault insurance state, many car accident injury claims are straightforward. It gets tricky if someone's injuries are severe and medical expenses exceed policy limits. Under these circumstances, you can go after the at-fault driver's insurance company for costs in excess of your own policy. Still, the other company may deny your claim. In that case, we will work to investigate the cause of the accident to prove liability and identify all other potentially liable parties. If the collision involved multiple parties, there might be numerous avenues to explore.  

While life insurance denials are rare, sometimes claims are rejected. It's challenging to get the decision reversed unless there is a legitimate error. Most claim denials are based upon issues of nonpayment of premiums, an omission or misrepresentation on the application, or the manner of death is not covered on the policy, such as suicide or death via an explicitly excluded activity. To fight a life insurance claim denial, you'll need to provide evidence that contradicts the reason for the rejection—for example, proof of premium payments, an autopsy report, and medical documents. Morgan and Morgan Law Firm can assist in appealing or preparing for a lawsuit so you can process the death of your loved one in peace. 

We understand that getting a lowball settlement offer can be a shock or, worse, having your insurance claim rejected outright. When you need help the most, getting more bad news is not what anyone wants to hear. Morgan and Morgan can help you fight back and recover the compensation that you're owed. We know how serious injury and setbacks can impact your life. You don't have to struggle on your own, and we're wise to every trick in the book when it comes to the insurance industry. We've recovered billions for our clients during the last 30+ years and will continue to fight for the rights of the people in the future. 

Contact us today for your free case evaluation.