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Insurance Company Disputes and Denial of Claims
What rights do you have when an insurance company denies your claim for benefits?
Many individuals and business owners have been notified that their claims for benefits pursuant to their insurance policies, have been denied. Our firm has been contacted by homeowners, automobile owners and tenants who were denied benefits by their insurance companies for claims made relating to damages from Superstorm Sandy. Individuals and business owners that believe their claim was unfairly denied by an insurance provider should contact our law firm for a complimentary consultation as we may be able to negotiate with your insurer or file a lawsuit to seek a reasonable and timely settlement or award.
Superstorm Sandy devastated the East Coast on October of 2012. Although the system has been classified as a storm and not a hurricane in many states (because it did not have sustained winds greater than of 74 miles per hour) it caused a considerable amount of damage. It has been reported that 121 people lost their lives as a result of the storm and that the economic damages will total more than $50 billion. Insurance providers are expected to received hundreds of thousands of claims, including about 200,000 for wind damage and 20,000 for flood damage from claimants living in 24 different states affected by the storm.
Given the significant volume of insurance claims and extent of damage, there is a higher probability that claimants will face delays, denials and underpayment of claims by their insurance providers.
Determining if a Superstorm Sandy insurance claim denial is invalid or illegal?
The following are reasons that a claim may be denied:
- The claimant waited too long to file a claim. Most insurance policies have deadlines, time frames within which policyholders must file claims in order to receive benefits. If the deadline expires, the claimant may face a denied claim.
- The type of damage was not covered by the insured's policy. If your property or homeowners' insurance policy does not cover the type of damage that occurred, your claim may be denied.
- The extent of damage is less than the policy deductible. If the deductible is $2,000 and the damage is valued at $1,000, the insurance company may not have to pay the claim.
- The policyholder let coverage lapse due to nonpayment or another issue. Nonpayment or another breach of contract may cause the coverage provided by an insurance policy to lapse. In this scenario, the insurance provider may deny the claim.
- Information provided in the claim form is inaccurate or incomplete. Even a misspelling of a name, incorrect property address or other mistake may cause a claim to be denied.
What to do when your claim for insurance is denied
If you received a denial in response to your insurance claim, there are several actions you can take to receive compensation due pursuant to the policy. First, you should contact your insurance company to determine why your claim was denied. In some cases, if an apparent mistake was made, it may be corrected. Keep detailed notes of pertaining to any contact you have had with your insurance provider. If the denial has not been reversed, you can submit an appeal letter to your insurance provider. This letter should be detailed, contain specific facts and supporting documentation. Our firm can assist you in preparing the appeal letter.
During any time after you receive a denial of your claim, you may also find it helpful to involve an attorney. Attempting to appeal a claim and even to get accurate information from your insurance provider can prove difficult. An attorney who is experienced in handling denied insurance claims may have better success in obtaining coverage. An attorney can also file a lawsuit on your behalf if you have been the victim of a breach of contract or insurance bad faith.