If you were injured in an accident or needed medical care and filed through insurance for coverage, you may not get your claim handled as smoothly and accurately as you think. Many insurance companies use technicalities and fine print as an excuse not to fulfill the terms of your insurance policy. When this happens, it is vital to have an attorney on your side. Not only can an attorney help protect your rights under your insurance policy, but they can also help you take your claim to court and ensure that you get the proper compensation you are entitled to. Call Ken Kieklak, Attorney at Law, to set up a free legal consultation with our Fayetteville insurance dispute attorney today.
Why Do Insurance Disputes Happen?
Insurance disputes can take different forms, but in the majority of cases, the dispute starts when an insurance company refuses to cover your claim. When you take out an insurance policy for auto insurance, health insurance, or other coverage, you expect the policy to pay you when you run into problems that are covered by the policy. Many car accident victims with first-party benefits run into insurance problems when their insurance carrier refuses to cover injuries after an accident, while medical insurance subscribers may run into problems if their carrier refuses to pay for procedures.
Insurance companies typically refuse to pay for one of two reasons: either the company has an argument that the situation is not covered, or they refuse your claim without proper justification.
When a claim is denied because the insurance company thinks it is not covered, the denial may cite a specific problem with the claim. In many cases, this justification may cite that you failed to pay insurance premiums, that information does not match with the insurance company’s records, that you did not seek prior approval, or that the incident falls under some clause eliminating the insurance company’s responsibility. An example of a clause that an insurance company might use to avoid paying a claim is a clause that refuses to cover intentional acts, or a common issue in car insurance cases is that the insurance company refuses to cover “commercial activity” if the accident occurred while driving for Uber or Lyft or working in food delivery.
If the insurance company gives no reason for the denial, it may be a stalling tactic used to delay making a decision, or the company may simply be trying to avoid having to pay for a claim. In any case, failing to give a valid reason or failing to pay a claim might be a breach of contract.
What Can a Lawyer Do Against an Insurance Company in an Insurance Dispute?
If your insurance company does not pay the claim as required in your insurance policy, you may be able to take them to court. Your insurance policy is a contract between you and the insurance company, under which the insurance company is legally obligated to pay you when the contract’s triggering terms are met. For instance, your auto insurance policy may require them to pay if you are injured in a car crash while your homeowners insurance may require them to pay if your house is damaged or destroyed or you suffered catastrophic injuries in another covered accident.
If your insurance company cites a specific reason under your policy that they do not have to pay, an attorney can fight their denial. Insurance companies have many processes for appeals, and you may be able to have an attorney appeal the denial to the insurance company. Sometimes, insurance companies look for specific language that laypeople might not understand. A lawyer can present your claim to the insurance company using the right language to show the claim should be covered. This may get your claim resolved more quickly and get you the compensation you need.
If your claim was denied for no reason, your insurance company refuses to discuss your claim, or you were given a pretextual excuse as to why they won’t cover you, you may be able to sue the insurance company for bad faith. Insurance companies are held to a standard of good faith and should make an effort to cover claims that are squarely within the scope of the insurance policy. If an insurance company fails to cite a good reason for denying the claim or they refuse to hear your claim, they may be violating their duty to you and their contract.
An attorney can take your claim to court and fight to get you the coverage you need if the insurance company is not willing to negotiate. If you were injured and need financial compensation, your attorney may also be able to take the at-fault parties to court and get you compensation for your personal injuries.
Fayetteville, Arkansas Insurance Dispute Lawyer Offering Free Legal Consultations
If you or a loved one has outstanding repair bills, medical bills, or other payments to make, and your insurance company refuses to pay you the coverage you deserve, call Fayetteville personal injury lawyer Ken Kieklak today. Ken Kieklak, Attorney at Law, offers free legal consultations on insurance dispute cases and fights to get clients the coverage they need. For help with your case, contact our law offices today at (479) 439-1843.