You pay your insurance premiums with the understanding that your policy will cover you in the event of accident, injury, or loss. When the insurer underpays or even denies your claim entirely, you’re going to feel angry, betrayed, and worried. How will you pay your bills or, in the case of property damage, restore your home or business?
Insurance claim denials occur when your insurer determines that they are not responsible for paying your claim. They may insist that you submitted your claim too late, your coverage has lapsed, or the policy doesn’t cover the accident or event you experienced. However, at the end of the day, insurance policies are contracts and the parties are generally bound by their terms unless a valid reason dictates otherwise.
Many claims presented to our law firm were improperly denied or underpaid by insurance companies. If your insurance claim has been denied or underpaid, you need a Houston insurance attorney fighting for your rights. The legal team at MyInsuranceCase has decades of experience in protecting the interests of Texas policyholders and will pursue the claim settlement you’re entitled to.
Why Are Insurance Claims Delayed or Denied?
According to a report by S&P Global Market Intelligence, the U.S. insurance industry recorded net premiums of $1.28 trillion in 2020, of which 51% were recorded by property/casualty insurers and 49% by life/annuity insurers. Despite their extensive assets and high profits, insurance companies continue to wrongfully deny claims to protect their bottom lines.
When you’ve experienced a fire, accident, or health crisis, the last thing you want to hear is that your claim has been denied. Johns Law Group represents policyholders in disputes involving the following types of claims:
- Property Insurance
- Life Insurance
- Health and Disability Insurance
- Commercial Insurance
Below are some of the most common reasons that insurance carriers give for claim denials.
- Claim Not Filed on Time: If you experience a loss or other covered event, you must notify your insurance company promptly. The insurer may state that you didn’t file your claim on time and are therefore not entitled to payment.
- Premiums Not Paid: Maintaining your premium payments is especially important. When you don’t pay your premiums on time, your coverage lapses. Your insurance provider may claim that you fell behind and they are no longer required to cover your losses. You should keep all receipts on file, so you can quickly prove that you made your premium payments if it is questioned.
- Claim Type Not Covered: Practically all types of insurance policies have exclusions. With property insurance, common exclusions include floods and earthquakes. If you have a life insurance policy, a claim may be denied if there is reason to believe that the insured committed suicide or engaged in dangerous activities.
- False or Misleading Statements: When you experience a covered loss, the insurer will investigate or request proof of damages. For example, when a damaging event occurs on your property, your insurance company will send an adjuster to investigate. If they find something suspicious or questionable, they may deny a claim.
- Insufficient Documentation: Once you file a claim, you need to provide evidence of damages and/or losses. For example, if you had a house fire, failure to submit a property inventory list, or proof of damage to the home can delay or prevent your claim settlement.
- Failure to Mitigate: Immediately following a property loss, the policyholder must protect their property from further damage. The failure to take reasonable steps to reduce the extent of the loss can lead to claim denial.
The unfortunate thing about insurance disputes is that they tend to occur when people are going through one of the most distressing times of their lives. At Johns Law Group, we understand the pressure that you and your family are under right now. Our skilled lawyers have the knowledge and experience to challenge an unjustifiable delay or denial.
How Can an Insurance Claim Denied Attorney Help You?
If your claim is unfairly denied, you may be able to file a bad-faith lawsuit against the insurer. Insurers who take advantage of struggling property owners or grieving family members can be held accountable by the courts. By taking legal action, you may be able to recover damages that are greater than the value of your policy.
Nevertheless, preparing, filing, and disputing insurance claims can be difficult. Many insurance companies want to pay out as little as possible on claims, and they have the financial and legal resources to help them maintain this position. The best way to ensure you get all the benefits you deserve under your insurance policy is to retain an insurance claim lawyer to represent you.
When you work with a Houston insurance denied attorney at Johns Law Group, it increases your chances of receiving fair compensation for your claim. We will-
- Carry out a thorough investigation
- Determine why your claim was being devalued or denied
- Communicate with your insurer on the matter so you don’t have to
If the insurance company appears to be acting in bad faith, we can help you file a lawsuit that holds them accountable and seeks appropriate damages.
What Are Common Reasons for Bad Faith Claims?
The point of insurance coverage is to protect policyholders and their families against future losses. However, insurance can only work if both policyholders and insurance companies keep their end of the bargain. If a policyholder buys coverage and pays on time, a company has a legal obligation to consider any claim submitted. Sadly, some insurance companies do not follow the rules and use the ‘delay, deny, defend’ strategy instead.
These actions are contrary to the Texas Insurance Code, which requires insurers to treat their policyholders with good faith. Specifically, Chapters 541 (Unfair Methods of Competition and Unfair or Deceptive Acts or Practices) and 542 (Processing and Settlement of Claims) state that insurance companies doing business in this state must:
- Investigate your claim promptly and properly
- Analyze the evidence fairly
- Honestly evaluate liability for your injuries or other losses
- Interpret the policy honestly when it comes to the claim
- Communicate with you about the claim
- Attempt to resolve the claim as quickly as possible
- Approve or deny your claim
- Explain any denial in writing
- Negotiate an insurance settlement in good faith.
After an accident or loss, contact an insurance claims attorney if you believe the insurer acted in bad faith by violating these requirements. If there is a valid dispute concerning a bad faith tactic, your attorney can pursue the appropriate recovery for the original loss as well as punitive damages related to the insurer’s illegal conduct.
Examples of bad faith practices in Texas include:
- Delaying the investigation of your claim without reasonable cause
- Failure to maintain reasonable communication with you
- Failure to investigate or decide your claim in a timely and efficient manner
- Delaying the processing of your legitimate claim without reasonable cause
- Changing or canceling your insurance policy after you have filed a claim
- Accusing you of fraud without reasonable justification
- Misrepresenting the policy language, documentation, or records to avoid liability
- Making unreasonable demands for duplicate documents or information
- Delaying the claims process by transferring your claim among numerous claims adjusters
- Denial of your claim without investigation or in violation of the policy
- Rejecting your claim without providing a reasonable explanation in writing
- Offering an unreasonably low settlement amount and refusing to negotiate
- Intimidation or pressure to accept an unreasonably low settlement offer
- Delaying payment after valid claims are resolved
As a policyholder, you have the right to fair treatment while your claim is being investigated and processed. If that doesn’t happen, you may be able to file a separate bad faith claim against the insurance provider and obtain additional compensation.
When Should You Hire an Insurance Denied Lawyer?
If you filed an insurance claim and it was unfairly denied, get a bad faith insurance lawyer involved right away. The sooner you act, the better your chances of getting the money you need to cover your damages. When you retain a Houston insurance denied attorney, it sends the message that you know what your claim is worth and you don’t intend to settle for anything less than fair and full value.
The insurance lawyers at MyInsuranceCase know what tactics these companies use to avoid paying out claims. We are also experienced trial lawyers and will make it clear that if the insurer refuses a fair settlement offer, they may be facing time-consuming and expensive litigation. This possibility alone may make them more amenable to paying the amount you are entitled to. If not, we are prepared to fight for your rights in court.
Speak to a Houston Insurance Denied Attorney Now
When you experience an expensive loss, you are probably depending on your insurance for the money you need to rebuild or recover. If your claim is unfairly denied, it can leave you feeling worried and hopeless.
At MyInsuranceCase, we are committed to protecting the rights of honest policyholders who are struggling with their insurance providers. Don’t get stuck paying for something that your insurance company should handle. Get in touch with our law firm to learn how we can help. We offer flexible fee arrangements for bad faith insurance claims and accept some cases on a contingency fee basis, meaning that you don’t pay us unless we recover money for you. To learn more, contact us today for a free initial consultation.