Insurance policyholders make regular payments and expect to have their claims covered promptly and fully if the need should arise. Unfortunately, this is often not what happens. Insurance companies are in business for profit. The top priority of their claims adjusters and representatives is to protect the company’s bottom line.
Many people believe that they pay their insurance companies, and that the companies work for them, but nothing could be further from the truth. Policyholders expect adjusters to act in good faith and promptly honor their claims.
Disputes arise when insurance companies deny claims that seem to be valid with no legitimate reason or explanation. In fact, some insurance companies routinely deny claims, whether legitimate or not, and only investigate after the policyholder takes legal action.
You pay your premiums, and you are entitled to the coverage you purchased under the terms of your policy. Speak with an experienced insurance law attorney if your provider has ignored or denied a valid claim, or made a settlement offer for far less than your claim is worth. Insurance adjusters have their companies’ best interests in mind, and you may need legal representation to resolve your dispute.
Our St. Augustine insurance lawyers at Morgan & Morgan have decades of experience helping clients recover the compensation they are entitled to receive from insurance companies. We can investigate your claim, deal with the insurance company on your behalf, and fight for your rights in court, if necessary. Complete our free case review form to learn more.
Insurance Company Reasons for Denying Claims
Insurance providers are motivated by self-interest (the cash reserves of the company) to avoid or minimize payouts. Some insurance companies employ various tactics to delay payment, reduce the amount paid out, or avoid paying a claim altogether. Providers may interpret or manipulate the language of a policy to serve their own purposes. Insurance companies may claim:
- The injury for which the claim is made falls outside the scope of the policy coverage.
- Coverage lapsed when the policyholder failed to pay premiums on time.
- There was a material misrepresentation in the policy, which excludes coverage on the claim in question.
Types of Insurance Disputes We Handle
Our insurance lawyers at Morgan & Morgan have years of experience representing policyholders in a range of insurance disputes, including:
- Auto insurance coverage
- Uninsured motorist coverage
- Personal injury protection (PIP)
- Health insurance claims
- Medical billing
- Homeowner’s policies
- Business property loss
- Disability insurance
- ERISA claims
- Professional liability coverage
- Errors & Omissions coverage
- Life insurance
- Fire, hurricane, and windstorm claims
Insurance Bad Faith and Unfair Claims Handling
Insurance policies act as contracts. Policyholders agree to pay premiums, and insurance companies agree to pay claims unless policy exclusions apply. Parties to any contract must act in good faith and enter into the contract with sincere and honest intentions. When an insurance company denies a claim without a legitimate reason, it may be acting in bad faith.
Most states, including Florida, have adopted the Unfair Claim Settlement Practices Act, which helps protect policyholders against unfair claims handling, examples of which include:
- Deceiving or misleading a policyholder
- Neglect or refusal to fulfill a contractual obligation
- Conscious wrongdoing
St. Augustine Insurance Claim Lawyers
Our dedicated attorneys at Morgan & Morgan take pride in the fact that we represent people – never insurance companies, hospitals, or large corporations. We are committed to pursuing the best possible outcome for our clients, and it shows in the results we have achieved.
If your insurance company has ignored or refused to pay a legitimate claim or substantially minimized the payout, contact us for a free case evaluation. We have the skills and knowledge to stand up for your rights if your insurance company has treated you unfairly.