- $13 Billion+ Won
- 800+ Lawyers Nationwide
- The Fee is FreeTM, Only Pay If We Win
- America’s Largest Injury Law Firm
- Protecting Families Since 1988
Pittsburgh Insurance Dispute Lawyers - Morgan & Morgan
We all know that dealing with the insurance claims process can be challenging, whether it’s because of a car accident or a flooded basement. Suppose you’re having trouble resolving a valid claim with your insurance company or another party’s insurance company is giving you the runaround. In that case, you may be on the hunt for the best Pittsburgh insurance dispute lawyers. Rest assured, the experienced insurance dispute lawyers at Morgan & Morgan Law Firm are here to help.
Insurance companies have a duty to act in good faith and deal with consumers fairly. While not every denied claim constitutes an act of bad faith or unfair handling of the claim, some insurance companies will work diligently to protect their bottom line, even if it means crossing into grey areas. Let’s go over some of the things you need to know about insurance disputes and the law.
What is an insurance dispute?
An insurance dispute occurs when a policyholder and an insurance company do not agree on the conclusion of the settlement. The insurance company may outright deny the claim or offer less than what the policyholder believes is a fair settlement. Additionally, an insurance dispute may arise if the claimant is experiencing a delay in payout without a reasonable explanation. In some instances, the insurance company can offer a reasonable explanation for their decision. Still, sometimes the policyholder may feel like the denial or reduced settlement was unfounded.
What are the kinds of insurance disputes?
When an insurance company denies a claim, the insurance company typically gives a reason for the denial. If the insured believes the decision was wrong, they can file an appeal to reevaluate the denial. After revaluation, if the insurance company comes back with the same decision and the insured believes the insurance company is acting in bad faith, an insurance dispute lawyer can counsel the insured on the next steps to take.
Along with claim denials, there are many other types of insurance disputes that can take place, including:
- Disagreements concerning increases in premiums
- Disagreements concerning policy coverage changes
- Misinformation from the insurance company
- Misunderstanding of tax benefits or discounts connected to insurance purchase
- Forged signatures or other unethical conduct
- Lapse in coverage without proper notification
Reasons your claim might be denied
Insurance companies use some common reasons to deny insurance claims, which can be tricky, such as the insured misunderstood language in the contract, for example. Some injuries, medical procedures, or events are not covered in the policy, or there was a lapse in coverage during the exact time frame for which the insured is making a claim. And finally, incomplete or inaccurate information was provided for the claim.
What about a car accident?
If you were in a car accident, you’re probably concerned with how the insurance company is going to handle it. You may feel like the settlement you are offered does not fully compensate you for your losses like medical costs, time off from work, and damages to your car. Your insurance company has told you their offer is the best they can do. But is it really? The important thing every consumer must understand is that the insurance company doesn’t necessarily have the final say. Also, if you’re dissatisfied with the offer, don’t accept it because that effectively ends the dispute.
If you were partially or wholly at fault for the accident, your car insurance company can, in some cases, outright deny your claim, as in the case of driving under the influence. Most policy coverage is automatically voided in this instance. Other illegal activities may void coverage, like an unlicensed driver wrecking your car after you give them permission to drive it.
Suppose you didn’t get a medical evaluation after the accident and realize you have injuries to your back, for example. In that case, your insurance might refuse to pay for treatment because they can argue that the car accident wasn’t the cause of the injury. That’s why it’s critical to get a medical evaluation after an accident. If you have an injury that can’t be diagnosed and treated like whiplash, your insurance company will not likely payout for this. The same goes for previously existing conditions, even if the car accident aggravated it and made it worse. It’s very difficult to determine if the car accident was at the root of it.
If your claim exceeds the maximum coverage of your policy, it’s unlikely you will be able to recover the difference through your insurance company. Although, depending on the circumstances, you may be able to seek compensation from another party if they were at fault.
And finally, if you didn’t report the accident to your insurance company in a timely manner, they can dispute that your coverage isn’t valid because they were not given the opportunity to investigate the accident, and evidence was lost.
What about homeowners insurance claim denials?
A homeowners insurance claim can be denied for a variety of reasons. Not enough information is a common cause because it’s the homeowner’s responsibility to provide proof of damages. As mentioned previously, with car insurance, taking too long to file could result in a denial of your claim. The time limit for filing claims should always be reviewed on any insurance policy you hold. Late payments can cause a lapse in coverage which the insurance company can use to deny your claim.
Insurance policy language is often hard to understand, so consumers need to read their policies carefully to recognize exclusions for coverage. Many homeowners policies will exclude damage from earthquakes or floods, for example. Learning this after the damage has occurred is devastating. but an insurance company may have valid cause to deny the claim
Can you dispute insurance claim denial?
Yes, you can dispute an insurance claim denial by following the procedures put forth by your insurance company. This process usually starts by contacting your insurance agent or insurance company. Review the original claim you filed to make sure there isn’t a way to improve your claim with additional information or evidence. For example, if you filed a claim for damages to your home but didn’t include estimates for repair, by doing so, you may improve your chances by submitting this additional evidence.
When you contact your insurance company after denial, ask if your claim can be reviewed again based on the new evidence. If they won’t review your claim, you can reach out to a third-party appraiser. The value of the third-party professional opinion is that they will either confirm the insurance company’s decision or give you the leverage you need to dispute their settlement offer.
When should I hire a lawyer for an insurance dispute?
If you’ve exhausted all other avenues to resolve your claim favorably, hiring Pittsburgh insurance dispute lawyers could be your best option for relief. Insurance companies are all about making profits and finding ways to pay as little as possible or denying coverage. If your claim is an expensive or complicated one, it will only add to the likelihood of shenanigans with the insurance company.
Our insurance dispute lawyers can help if you’re having trouble establishing fault. They can examine the legalese of your policy to make sure there is no misunderstanding of the interpretation. Furthermore, they can assist with all other elements of your claim, like speaking to the insurance company, negotiating the settlement, and filing legal paperwork. And, if necessary, bringing a lawsuit against the insurance company if there is no other way to remedy the issue.
Hiring our lawyers definitely increases your chances of success with an insurance dispute because we are keenly aware of the tactics insurance companies routinely use to undervalue and deny valid claims. Your claim may have been automatically rejected if the insurance company knows it will take a lot of work to prove your claim. They literally bank on the hope you will just go away if it’s going to be an uphill battle. But with a Morgan & Morgan insurance dispute lawyer representing you, it could be a totally different story.
What is a bad faith claim against an insurance company?
As stated previously, simply denying a claim or having a difference in opinion on the adjuster’s estimate does not automatically mean the insurance company is acting in bad faith. If they are able to support their findings and conclusions, it may very well be their decision is valid. However, some insurance companies genuinely act in bad faith when they ignore evidence that supports your claim, or they purposefully drag out the process to frustrate their policyholder in the hopes the policyholder will just give up.
In Pennsylvania, the courts have established that plaintiffs must prove there is no reasonable basis for denial of insurance benefits, and the insurer knew or recklessly ignored its lack of reasonable basis in denying the insured’s claim.
Insurance companies that are found to have acted in bad faith in the state of Pennsylvania can be ordered to pay damages above and beyond the policy limits as a form of punishment for their actions. They may get hit with penalties, and the plaintiff could receive damages for economic losses, interest, emotional distress, and punitive damages. This latter is typically determined by how much the insured’s loss was and the wealth of the insurance company.
Pittsburgh insurance dispute lawyers
If you feel you’ve been the victim of unethical treatment by your insurance company, our insurance dispute lawyers may be able to help you. Insurance companies don’t always have the final say when it comes to insurance disputes. Our lawyers can examine all of the evidence pertinent to your claim to assess whether legal action can be taken to resolve your claim favorably. Don’t hesitate to reach out for a free case evaluation today.