Lawyer for Denied Insurance claims in florida
When the unexpected happens, insurance plays a critical role. The right insurance policy can pay for an emergency room visit, replace a roof, or cover vehicle repairs.
However, every insurance company wants to protect its bottom line, which means claims often get denied.
A denied claim can wreak financial and emotional havoc, but you have the option to challenge it — and the best way to increase your chances of a positive outcome is to work with a denied insurance claims lawyer. Florida homeowners should understand that when it comes to insurance claim denials, they have options.
Understanding Denied Insurance Claims
When an insurance company denies a claim, it tells you that it’s unwilling to pay it. Insurers commonly cite the following reasons for denial:
Lack of Documentation
Sometimes, the insurance company will say you haven’t adequately documented your need for coverage. For example, if you submitted a car accident claim but didn’t include a police report, the insurer may decline to pay.
Disputed Policy Language or Exclusions
Insurance companies try to make policy wording as clear as possible. However, an insurer can sometimes interpret a policy differently than you do, saying that something you believe should be covered is actually excluded from the policy.
Missed Deadlines or Procedural Errors
Insurance companies set limits on how long you have to file claims. For example, many home insurance companies give you one year from the date of damage to file.
If you file after that deadline (or the insurance company claims you did), the insurer might deny your claim. They also might deny it if you don’t follow their claim submission guidelines to the letter.
Claims Considered Excessive or Fraudulent
Insurers might sometimes refuse claims if they believe you’ve overstated the value of the damage or fabricated the claim entirely. Claim denials happen throughout the insurance industry. Any of the following claim types can be denied:
- Homeowners insurance
- Health insurance
- Auto insurance
- Life insurance
- Business interruption insurance
- Property damage claims
- Flood and hurricane insurance in Florida
Hurricane and flood insurance denials can be especially distressing. Florida homeowners purchase this type of insurance coverage because they understand the state’s climate puts them at disproportionate risk. With an insurance claim denied, they may be left with a badly damaged or destroyed home and seemingly no recourse.
Fortunately, when valid claims are denied, a bad-faith insurance lawyer may be able to help.
Dealing With Insurance Company Tactics
Insurance companies won’t always deny claims outright. Sometimes, they deliberately delay or try to confuse you using various tactics.
Delayed Responses or Stonewalling
Instead of denying a claim immediately, some insurance companies might try to wear you down over time. They may deliberately take too long to respond, hoping the drawn-out process will make you more willing to accept a lower payout.
Insurance companies benefit from stonewalling. The longer they hold onto their money, the more interest it generates, boosting their profits.
Misinterpreting Policy Terms
If you submit a valid claim and get a convoluted-sounding denial full of industry jargon, you might be a victim of deliberate misinterpretation.
Some particularly unscrupulous insurance companies deliberately misinterpret their own policies to deny legitimate claims. This is a blatant bad-faith denial tactic, and an experienced denied claim lawyer can help you make things right.
Underpayment Offers
In some cases, an insurer might offer to pay far less than a claim is worth. If a policyholder is in a desperate situation, they may be willing to accept a serious underpayment.
As a policyholder, you don’t have to accept these underhanded tactics. Many insurers behave this way because they think they can get away with it. However, denied insurance claim attorneys see through these schemes, and they can hold unethical insurers accountable.
Appealing a Denied Insurance Claim
If your insurance provider has denied your claim, you have the right to appeal. While it’s important to file your appeal fairly quickly, you don’t want to rush it. The more thorough and well-documented your appeal is, the more likely it is to be approved. Here are the steps to take:
Reviewing the Denial Letter and Policy Terms
Before doing anything else, carefully read the insurer’s reasons for denial and the terms of your policy. Are they denying coverage for something the policy says should be included?
Gathering Supporting Evidence and Documentation
Even if your claim wasn’t denied because of insufficient documentation, more documentation always helps. Including detailed records may make it harder for the insurer to deny your appeal.
Writing a Formal Appeal Letter
Your appeal letter should clearly (and civilly) outline why your claim was wrongfully denied. While it’s understandable to be frustrated or angry with the insurance company, remember that your appeal letter is a formal document, and you should always remain polite and professional.
Communicating Effectively With the Insurer
The process of appealing a denied insurance claim can take time and may require ongoing communication with the insurer. Replying promptly to any questions or requests for additional information can go a long way toward getting your appeal approved.
The timeline of an appeal depends on the type of insurance policy you have, where you live, and the particulars of your claim. For example, appeals of homeowners insurance claims can take several weeks or months.
While you can file an appeal yourself, it’s often wise to have the help of an experienced attorney. Insurance claim lawyers understand what to include in an appeal to increase the chances of approval. If the appeal is rejected and the insurance company is clearly acting in bad faith, your attorney can help you take legal action.
Tips for Successful Insurance Claim Appeal
There’s a lot on the line when you file an appeal. Keep these tips in mind to maximize your chances of success:
Be Proactive and Organized
Putting together an appeal can be overwhelming, but staying organized is key. Keep all materials related to your appeal in one place, and write down all important deadlines to avoid missing them.
Maintain Detailed Records of All Communications
It’s easy to get lost in the back-and-forth with the insurance company. To make sure you don’t forget any crucial information, take notes during each phone call.
You should also keep a log of the date and time of every communication (whether on the phone or via email). If it eventually becomes necessary to file a lawsuit against the insurer, this record will prove to be highly valuable.
Ensure Your Documentation Is Thorough and Accurate
Quality documentation is an important part of any appeal. It may help to look over your documentation as if you were someone else. Do the materials you’re submitting clearly substantiate your claim?
Understand the Policy Terms and Exclusions
You should thoroughly understand what your policy includes (and doesn’t include) before you get started. If you refer to your policy document in your appeal and explain why your claim should be approved, the insurance company will have a harder time denying your appeal.
Avoid Signing Anything Without Review by Legal Counsel
Getting offered anything at all after filing an appeal can seem like a victory. However, it’s still possible that your insurer may try to offer you less than your claim is actually worth. Never let an insurance company pressure you into signing something without having your lawyer review it for you first.
The Appraisal Process
If your insurer is paying part of your homeowners insurance claim but is offering far less than the cost of the damage, you don’t have to go straight to litigation — homeowners insurance claim denial help is available. The insurance appraisal process Florida offers homeowners is a faster (and less expensive) way to resolve insurance disputes.
With this process, you and the insurance company each select an independent appraiser to evaluate the damage to your home. The two appraisers assess the damage and then come to a consensus on the cost of repair. The insurance company must then pay you that amount. If the appraisers can’t agree on a value, they’ll select an umpire, or impartial third party, to resolve the disagreement.
The appraisal process can be useful in insurance disputes where you and your insurer don’t agree on the value of your claim. However, if you’re dealing with an outright denial of something you think should be a covered loss, it might be more appropriate to take legal action.
Suing the Insurance Company
If all else fails, you may need to consider suing insurance company for denied claim. There are two main situations where litigation becomes necessary:
- The insurer is engaging in bad-faith insurance practices like unreasonable delays, failing to explain denials, or undervaluing claims
- The insurer continues to deny claims despite sufficient evidence
Here are the steps involved in a bad-faith insurance lawsuit:
Initial Consultation With a Lawyer
At this meeting, your prospective attorney will discuss your situation with you and help you decide whether filing a lawsuit is the best option.
Pre-Litigation Negotiations
If you decide to hire a particular attorney, they’ll start working on your case by attempting to negotiate with the insurer. Many insurance companies want to avoid the expense and publicity of litigation, so they may agree to settle with you right away by paying your claim.
Filing the Complaint and Proceeding to Court
If the insurance company is unwilling to settle, your attorney will proceed with a formal lawsuit. If you win in court, the insurer will be ordered to pay the full value of your claim (up to your stated policy limits).
In cases where an insurer has clearly acted in bad faith, they may also be ordered to pay punitive damages, which are meant to punish the defendant for egregious wrongdoing.
Get Help From a Florida Denied Insurance Claim Lawyer
Bad faith claim denials aren’t just unethical — they’re illegal. Taking on your insurance company might seem intimidating, but when you have the help of a skilled lawyer for denied insurance claims, you can proceed with confidence.
Kennon Law is proud to represent Florida homeowners and businesses as they stand up to insurers acting in bad faith. We have more than 30 years of combined experience in insurance law, and we’re ready to put it to work for you. Contact us today to schedule your free consultation!
Frequently Asked Questions
Do Denied Claims Count Against You?
A denied claim won’t usually impact your insurance premiums. However, a history of multiple claims (even denied claims) might.
How Can I Avoid Claim Denials in the Future?
You can reduce the risk of claim denials by submitting complete, accurate documentation with your claim and making sure you follow your insurer’s claim submission guidelines precisely.
How Can I Determine Why My Insurance Claim Was Denied?
Your insurance company should include a reason for the denial in your denial letter. You can also contact them directly to ask about the denial.
What Is the Difference Between a Claim Rejection and a Claim Denial?
A rejected claim is returned to you before processing, usually because of a formatting error or because it’s missing information. A denied claim is one the insurer has processed and determined to be non-payable.
What Should I Do if My Claim Denial Seems Unfair or Incorrect?
Filing an appeal is your best option. A qualified attorney will be able to guide you through the process and help you take your next steps.
What Is One of the Most Common Reasons for a Claim Being Rejected by an Insurance Company?
Claims are commonly rejected for missing or incorrect information. However, some insurers might attempt to deny valid claims for illegitimate reasons.
Can I Appeal a Denied Insurance Claim, and How Do I Start the Process?
Certainly. Each insurance company has its own appeal procedure, and your denial should include information on how to start the appeals process.
Is There a Time Limit for Appealing Denied Insurance Claims?
Different insurance companies have different time limits. In most cases, however, you’ll have about six months to file an appeal for a denied homeowners insurance claim.
Are There State or Federal Laws That Protect Me in Case of a Denied Insurance Claim?
Yes. Florida (like many states) has a bad faith insurance law that allows you to recover damages if an insurer fails to fulfill its contractual obligations.
How Do I Deal With a Rejected Insurance Claim?
If your claim is rejected, you must fix the missing, incorrect, or incomplete information before re-submitting it. Contact the insurance company to ask what needs to be changed if necessary.
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