6 Steps to Take if Your Insurance Company Denies a Legitimate Claim


NHurricane-Insurance-Claim-Rejectedo one ever prays or hopes for bad things to happen to them. However, when it does, and you have insurance, it is only normal that you would want your insurance company to pay your compensation seeing as it is technically your money.

However, when you file for your compensation and get the dreaded “compensation claim denied,” what do you do? What other options do you have? Should you just throw in the towel and walk away, or fight to get your insurance claim paid, particularly when you have been dutifully paying your premiums?

Find out the Possible Reason for the Denial

Why did you insurance firm refuse to pay out your compensation? Is it possible that your coverage did not extend to the particular claim you are filing? Is it possible that you did something wrong? Alternatively, did you maybe miss out some important details when you submitted your claim?

Is it possible that your evidence wasn’t very detailed and clear? Did someone enter the wrong information whilst evaluating or documenting your claims?

These are just some of the things you need to get an answer to. Most times, the reason insurance companies deny their policy holder’s claims is because there were either administrative errors in their filing or the policy the claimant took doesn’t extend to their claims. Some other less common reasons include the lack of careful attention by the claimant when filing their claims.

Get Back in Touch with the Insurance Company

Once you have ascertained what the possible reason for the denial could be and still feel that you have a legitimate claim, make the necessary corrections and get back in touch with the insurance company. Usually, if you were denied because of some of those mistakes, you could get approved for the claims when you send in the right documents.

Get an Independent Assessment

In the event that the insurance company still maintains that they will not pay the compensation or will underpay you (for instance, claiming damage to be wear and tear and not the result of an accident), you will need to get an independent assessment of the car. When you do, contact the insurance company and let them know of your findings.

Contact the Ombudsman Service

If, after all these, you get a “final notice of denial” letter or don’t hear from them for over two months, it is time for you to contact the Ombudsman service in your state. This service will look into the matter and make a final judgment on the situation. Usually, their verdict is final and binding. Moreover, the insurance company will be compelled to pay you.

Get a State Insurance Regulator Involved

In the event that a decision from the Ombudsman is rejected by the insurance company, your next option is to contact the state insurance regulator. They will then investigate the matter and inform you of their findings. If your claims are legitimate, you will get an added “nod” or recommendation from them. Usually the insurance company will comply with the state insurance regulator’s verdict.

Take Them to Court

This should be a last resort as insurance cases can take years before they get resolved. That may be time you do not have when you need to fix your home or buy a new car. However, if you do not have any other option or were underpaid, consult an insurance attorney and speak to them about this. If the case is legitimate and they feel that you have a good chance of getting a bigger payout, they will let you know. Just be prepared for the case to go on for a while.

Oscar King has worked as an insurance adjuster for years, and has learned all the tricks of the insurance trade, and recently left his job to write articles helping others learn how to get their deserved payout. For handling injuries suffered as a result of an accident or other incident, he highly recommends Orlando area residents contact Personal Injury Attorney David Heil. You can learn more about Oscar and see other writing examples on Google+.

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