When Your Insurance Company Will Not Pay

You filed a claim with your insurance company, expecting to receive reimbursement for your loss, but they denied your claim or offer way too little. Now what? Here in Florida, this is a common problem and we are here to help. Most importantly, if you are not happy with their response, do not sign anything until we talk.  

Whether it’s car insurance, business interruption insurance, homeowner’s insurance, or any other type of insurance, the company is in business to make money. I do not mean to paint with a broad brush, suggesting that insurance companies are dishonest or unwilling to help their customers, but the fact remains that they do need to make a profit for their stockholders. Thus, unless the coverage is very clearly defined in your policy, there may be ways to decrease or deny a payout. 

Let’s look at some of the reasons why your claim may have been denied and what you can do. Do not sign anything or cash any checks until you have attempted a dispute process or spoken to an attorney experienced in resolving insurance disputes. 

Insurer issues

As mentioned, some insurance companies may have a culture that encourages denial. But sometimes it’s just a matter of overwork, stress, or incompetence. Denials are faster and easier for the overworked claims adjuster, especially if your claim is complex or has a great deal of documentation. 

Some companies don’t train their adjusters well, so they’re not very knowledgeable, and some companies don’t treat their adjusters very well, breeding low morale and thus poor work. And adjusters are human, with their own biases and egos. I have seen very clear, valid claims denied for inexplicable reasons, leading me to assume that one of the above issues – overwork, incompetence, or attitude – was at play in the initial denial. 

Claim issues

Sometimes, however, there are issues in the claim itself that justify the denial or low payout. Some of these issues can be overcome or argued away, however, when a policyholder has the right legal counsel. 

Possible reasons for denial may include:

  • Insufficient coverage: If a car accident causes $25,000 of damage but your policy only covers $10,000, that’s the maximum that can be paid
  • Policy exclusions: If your home was damaged in a flood but you don’t have a flood insurance rider on your homeowner’s policy, flood damage would not be covered
  • Procedure errors: You may simply have not filled out the paperwork correctly
  • Time lapsed: You may not have submitted your claim within the timeframe required in your policy
  • Liability: This can be complicated. If you believe you were negligent and caused damage to someone else’s property or caused an injury to someone else, you expect your insurance company to pay. However, if your insurance company disagrees and does not think you were liable for the damage, they will deny the claim.

These are some of the most common issues I’ve seen where there is a problem from the policyholder’s perspective. Whether the problem is with the company or with you, there are still steps you can take to collect on your claim. 

What you can do

As stated, don’t sign anything or agree to a settlement before speaking to an experienced attorney, and don’t cash any checks from the insurer. This may be hard to resist since you probably have bills to pay, but using their money could be construed as accepting their decision. 

I have helped hundreds of Florida residents receive compensation when their initial claims were denied and I’ll do my best for you, too. But the first step is to look at your case together. Collect all of your data – facts of the claim, any records, and the reason for the denial. Bring any photos of the incident, before/after pictures, and eyewitness reports. Bring me medical bills, repair bills, or estimates associated with the claim. Together we’ll review your situation and help you file an appeal. 

As a personal injury attorney, my goal is to fight for the “little guy” against the insurance companies who can afford to hire lawyers to intimidate you and prevent you from getting the just compensation you deserve for your damages. Contact me 24/7 at (954) 448-7288 from anywhere in Florida to schedule a free consultation to see how I can help you.

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