When you file a claim with an insurance company, you expect them to take some time to review your documents. What you don’t expect is waiting months for a vague response, and this is just an example of a tactic some insurance companies may use to avoid paying out a claim.
Most insurance companies are devoted to providing fair and ethical services, but unfortunately, not all. We’re unraveling insurance company tactics so you’re in a better position to respond. We’ll also look at some common mistakes that can show up on insurance claim forms. Even a simple error can cause a lengthy delay.
Common Insurance Company Tactics
We briefly mentioned delaying a claim’s approval as an insurance tactic. When you contact the insurance company, you can’t seem to get an answer.
When this happens, the insurance company is trying to delay giving you a response. They’re hoping you give up pursuing a claim. The insurance company may also be trying to sit on your claim until you miss a deadline. Instead of refiling a claim, they’re hoping you go away.
Persistence can help overcome this roadblock. If you still can’t get a response, it may be time to work with an attorney. Here’s a look at some other common tactics used by insurance companies to stall or deny a claim.
Deny the Claim for a Vague Excuse
Insurance companies can try to deny a claim for a vague excuse. They may try to say since the at-fault driver’s actions are negligent, the incident is intentional and not an accident. To be fair, the insurance only covers accidents and not intentional events. However, the claim doesn’t meet the legal definition of intentional.
Even if the at-fault driver intentionally caused the vehicle collision, it’s still an accident with an injured party. In other words, insurance companies can’t deny an accident claim simply because the at-fault party may have acted intentionally.
Other vague excuses can include non-coverage for certain types of car accidents. You can usually get through this hurdle by reading the policy’s fine print. If you’re filing a claim with an insurance company other than yours, you should be able to request a copy of their rules and guidelines.
Canceling the Policy After Filing a Claim
Unfortunately, insurance providers can cancel policies for just about any reason. While most insurance companies go through a process when a policy is being terminated, not all follow basic steps. This includes alerting the policyholder of the upcoming cancellation and providing a valid reason for terminating the relationship.
If your policy is canceled immediately after you file a claim, your only solution may be to file a complaint against the insurance company. This usually involves contacting your state’s attorney general. You should also consider retaining legal representation.
Reasons Your Claim Can Be Denied
Sometimes, insurance companies deny claims for valid reasons. You can always file an appeal, especially if a mistake in your documentation is the reason for the denial.
Limitations in Policy Coverage
Most insurance policies have limits, as known as caps. The limit refers to the highest amount the insurance company will pay out on a claim. Submitting a claim for an amount over the policy limit can result in an automatic denial.
However, don’t panic. This type of denial is usually easy to resolve by filing a claim under the policy’s cap. What happens if you still have outstanding damages? You can file a claim against the individual responsible for causing the accident. This is typically a lawsuit you and your attorney file in civil court.
Exclusions
Not all insurance policies cover every type of accident. For example, homeowners insurance rarely covers flood damage. If you only have liability insurance, your property damage isn’t covered.
Filing a claim for an exclusion in your policy will result in a denial. You also can’t increase the coverage amount or type right before filing a claim. Most insurance companies have a waiting period before additional coverage goes into effect. The best way of avoiding this issue is to read through your policy’s exclusions before filing a claim.
Pre-Existing Conditions
This is another time it’s a good idea to read the fine print in your policy. Pre-existing conditions aren’t always covered as damages. However, even if your pre-existing condition is an exclusion, you may still be able to file for compensation.
Using the eggshell doctrine, you may be able to receive compensation for the at-fault party’s insurer. The doctrine basically holds a defendant liable for a plaintiff’s injuries even if a pre-existing condition is the underlying cause.
For example, if you suffer from brittle bone syndrome and the accident results in a broken leg. The defendant’s insurance company can’t deny your claim. Your condition may increase the likelihood of you suffering a broken bone but it’s not the primary factor.
Delay Reporting the Accident
Insurance companies may decline your claim if you wait too long to report the accident. Most states give you up to ten days and you don’t want to wait any longer to contact your insurer. Contacting the insurance company doesn’t mean you’re filing a claim. You’re still collecting your evidence and calculating your damages.
All you’re doing is letting the insurance adjuster know the accident occurred and you sustained damages, which allows the insurance company to make a note in your file. They may even start researching the accident to ensure the official report lines up with your claim.
Lack of Documentation
When you submit your claim, you must provide supporting documentation. This includes your accident report and medical records, along with bills and receipts proving other listed damages. Forgetting to include documentation for each listed item on your claim can significantly delay the process.
Your claim may not be delayed but the process can drag out while the insurance adjuster reviews each missing document.
Don’t Let the Insurance Company Delay or Deny Your Accident Claim
Insurance companies can use several tactics in hopes of not having to pay out claims. You can also make mistakes that lead to delays and denials. Working with an experienced accident attorney is the best way to avoid any hassles. They understand the tactics insurance companies often use and can keep you from making any mistakes.
Having a knowledgeable attorney on your side can streamline the process and help you secure the compensation you deserve. Their expertise provides peace of mind and ensures that your rights are protected throughout the claims process.
