Insurance Dispute Lawyer

Insurance policies are designed to provide us with a sense of security to deal with life’s many uncertainties. Whether it’s health, property, travel, or anything else, we diligently contribute to our insurance funds so we can be compensated if we ever suffer a financial setback due to a life event.

Despite our best efforts, sometimes insurance companies refuse to pay when the time comes. For instance, the healthcare industry is an arena that has witnessed countless claim denials and rejections. Many insurers refuse to pay all or part of the claim amount for reasons ranging from simple clerical errors to unethical reasons. In such situations, an insurance dispute lawyer can be your strongest ally to help you fight delayed, denied, or undervalued insurance claims.

Can You Dispute an Insurance Claim?

Policyholders who disagree with their insurance company’s decision are entitled to dispute it. Say you pay for medical care, and your health plan denies benefits for covered and medically necessary services. In that case, you should be able to appeal your denied health insurance claim.

While some insurers will promptly pay your claim in the event of a genuine mistake on their end, many companies drag out insurance claim disputes for a long period. This is typically the case for complex disputes, where the insurer will use its resources to keep the dispute going until the policyholder gives up. If you are tired of fighting for your rights, it is easier and more effective to hire an experienced insurance claim lawyer who will represent your best interests to negotiate a favorable resolution.

When Should You Hear Back About an Insurance Claim?

Waiting to hear back on a final decision from your insurance company is often the most challenging part. Rules vary by state, but insurance companies typically take up to 40 days to accept or deny a claim, followed by up to 30 days to pay out a claim after a final order. In Wisconsin, for example, insurers have about 30 days to provide an update on your claim. A Wisconsin insurance dispute lawyer can advise you on state laws regarding the payment of an insurance claim.

What Are the Most Common First-Party Insurance Claims?

A first-party insurance claim is between the policyholder and the insurance company. For instance, the policyholder in a first-party insurance claim might be a homeowner who suffers wind damage to their home and files a claim with their insurer to cover applicable damages and repairs.

On the other hand, a third-party claim is filed with another person’s insurance company and may include multiple parties.

First-party insurance claims usually involve health, travel, property damage, life, and commercial property insurance. The insurance dispute lawyers at Wallace Law specialize in first-party insurance claims.

1. Health Insurance

Health insurance allows children and adults access to medical services. Depending on the policy, your health insurance may fully or partially cover doctor appointments, procedures, surgeries, and more. Despite the promise of coverage, health insurers sometimes deny medically necessary care and try to underpay or deny claims. A health insurance dispute attorney can help you fight unreasonable denials.

2. Travel Insurance

Vacation is fun until the unexpected happens, like a medical emergency, delayed luggage, or flight cancellation. Travel insurance is a shield from certain financial losses. When travel insurance carriers refuse their contractual obligations, insurance claim attorneys can fight unjust travel insurance denials.

3. Property Damage

Having your home destroyed in full or in part due to a natural disaster or a covered event can put you in a very difficult financial position. Common types of property damage under a home insurance claim include:

• Hail damage can look like dents and dings in a home’s exterior, shattered glass, or water seepage.
• Water damage or any physical interior and exterior harm like leaky plumbing, and other problems caused by floods, tornadoes, plumbing issues, or faulty appliances.
• Fire damage to interior walls and structures is caused by flames or smoke and other corrosive substances emitted by fire.
• Wind damage due to a storm and damaging winds that destroy roofs, windows, and more.

If you have met all of the conditions of your coverage but your insurance company continues to deny or stall a claim, it might be time to speak to a property insurance dispute lawyer.

4. Life Insurance

Life insurance provides support after the passing of a loved one. Unfortunately, many life insurance companies take advantage of a vulnerable situation and deny legitimate benefits. A life insurance dispute lawyer can help contest a wrongfully denied claim so you can take care of immediate and future expenses following a loved one’s death.

5. Commercial Property Insurance

Weather-related incidents like winter storms, tornados, and unexpected accidents like property theft can result in costly damage, expensive property repairs, business interruptions, and loss of income.

Commercial property is a financial safety net until an insurer denies, delays, or underpays your claim. Instead of accepting a low settlement or wasting time battling an insurance company for months, you should consider hiring a commercial property insurance dispute lawyer for help.

Why Was My Insurance Claim Denied?

A denied insurance claim is often worse news than the unexpected event that caused the claim, as you may be on the hook for significant losses if your insurance company refuses to pay. Claims get denied for many reasons, but the good news is that insurance claim decisions are not always final. In other words, simple mistakes and bad faith practices responsible for the denial can often be course-corrected.

Below, we discuss some of the common reasons for insurance claim denials.

1. The Loss Wasn’t Part of the Policy

All insurance contracts contain certain policy exclusions. For example, a homeowners insurance contract may not cover water damage in areas prone to regular hurricanes. This was the case for homeowners after Hurricane Ian and Hurricane Sally hit. Many Ian victims sued their insurance companies for underpaying damage claims after the devastating tropical storm, leaving the Florida Office of Insurance Regulation investigating multiple baseless complaints.

2. Claim Error

Mistakes and simple clerical errors are one of the most common reasons insurance claims get denied.

3. Bad Faith Practices

The practice of insurance companies using unethical means to boost their revenue is known as bad faith insurance. Insurers can be held liable for violating contracts and mistreating policyholders by unjustly denying or undervaluing claims. Bad faith insurance tactics include unreasonable delays, policy language misinterpretation, threatening language, or other unprofessional tricks.

What Type of Lawyer Should I Hire for an Insurance Claim?

Many policyholders wonder whether a personal injury lawyer is the right fit to fight first-party insurance disputes. It is important to note the key difference between first-party and third-party insurance claims: A typical first-party insurance claim includes services such as health, travel, life, or property insurance. On the other hand, a third-party claim involves a negligent party or entity that caused an injury and whose insurer is accordingly liable to compensate the innocent party. Examples of third-party claims are car accidents and slip and fall claims.

If you are looking to hire a first-party insurance dispute lawyer, look no further than Wallace Law. Our founder, Justin Wallace, along with the rest of the legal team can help you sue an unethical insurance company so you may recover your losses on time. Our combined experience and knowledge of insurance coverage disputes make us adept at beating insurance companies at their own game.

How To Dispute an Insurance Claim: 5 Steps

While there is no telling how an insurance company will respond to a claim dispute, how thoroughly you prepare a complaint can increase your chances of successfully resolving the issue. There are five steps to filing an insurance complaint:

1. Find Out Why the Claim Was Denied: Review the specific reasons for your claim denial and cross-reference the reasons provided against the terms of your insurance policy.
2. Seek Out an Independent Claims Adjuster: Consult an independent claims adjuster, not one that has a relationship with your insurance company, to gather information and assist with negotiating a fair settlement price.
3. File a Complaint: File an internal appeal to raise your concerns regarding the insurance claim denial decision and/or claims handling process.
4. Hire an Insurance Dispute Attorney: Consider taking legal action if you have not been able to reach a satisfactory resolution with the insurer.
5. Work With Your Insurance Claims Attorney: Have an insurance claims attorney handle all communication and negotiation with the insurance company to find you an amicable solution.

An Insurance Dispute Lawyer Is Here To Talk Today

Policyholders often go through multiple failed attempts to get suitable compensation from their insurance company before considering legal action. This can waste precious time as dragging out the process is a common tactic employed by insurance companies who want to delay, deny, or undervalue insurance claims.

At Wallace Law, our team of insurance dispute lawyers is ready and willing to help you fight insurance companies so you don’t have to. With years of experience, legal knowledge, and overall expertise, we can help you fight bad faith insurance practices. Contact us today to see how we can make a difference in your insurance dispute case.