Insurance claims are supposed to follow a predictable path. A loss occurs. The policyholder reports it. The insurance company investigates and either pays the claim or explains, clearly and promptly, why coverage does not apply. When that process breaks down because the insurer acts unreasonably or unfairly, the issue may rise to the level of […]

A health insurance claim denial can come as a shock, especially when the insurer’s explanation is that the treatment was “not medically necessary.” Patients often hear this phrase after a doctor has already recommended or provided care, leaving them confused about why coverage was refused. A denial based on medical necessity does not always mean […]

Life insurance denials are common, but many can be overturned. Learn why claims get denied, what evidence you need, and how to challenge the decision effectively.

Insurance companies deny claims for many reasons—from policy exclusions to bad-faith tactics. Here’s how denials happen and what legal steps you can take to challenge them.

Renters’ insurance protects tenants of rental property from damages related to smoke, fire, explosions, and other acts of god. It exists to help tenants in the event of a major accident to recover any financial losses. Renters’ insurance can cover a wide variety of accidents, natural disasters, and vandalism, though exactly what is covered depends […]

Don’t let your insurance company leave you with unsafe conditions or unfair bills. If your claim has been denied or underpaid, you have options. Contact Wallace Law today for a free case evaluation, and we’ll get to work reviewing your coverage and picking up your claim exactly where it is.

You pay your insurance premiums expecting protection in your time of need. But when a hailstorm tears through your neighborhood and damages your roof, the last thing you want to hear is that your claim has been denied. Sadly, that is precisely what happens to many homeowners and business owners across Wisconsin. At Wallace Law, […]

One hailstorm can create thousands of insurance claims on a single insurer, so it’s no surprise that they try to minimize payouts for hail damage when they can.

What you do in the aftermath of the fire is critically important both to your insurance claim and to preserving the value of your property.

No matter what insurance provider you get your coverage through, there is always a chance that you will have to contend with denial. Familiarizing yourself with health insurance denial rates by company is part of the picture, but so is understanding how to push back against unjust claim denials.

Applying for long-term care insurance can be frustrating because there is often a short window of time between when a person starts displaying a need for long-term care and when their condition or age has progressed to the point of becoming ineligible for long-term care insurance.

It may take up to 30 days for the insurer to review the claim and make a decision. Additional time may be necessary if the patient decides to appeal the insurance company's decision or take legal action.

When alcohol consumption ties into the death of the policyholder, life insurance claims can and do get denied. Many states allow life insurance companies to add exclusions to their policies when deaths result, either directly or indirectly, from alcohol use.

You purchase home insurance to protect yourself and your home. However, insurance companies primarily sell insurance to make money, so it is not surprising that most insurance policies have a laundry list of exclusions.

Many factors affect when you will hear from your adjuster after filing an initial claim. Some companies return calls within 24-48 hours, while other, smaller companies may take longer to contact you.

Typically, renters insurance may cover a number of expenses and losses stemming from sudden, accidental damage, provided that negligence was not the cause. Renters insurance is more likely to cover a sudden and unanticipated event that occurs in your dwelling like a burst water pipe (provided you were not somehow negligent). Generally, renters insurance will not cover water damage caused by a flood.