We all count on insurance to be there for us when we need it. But often we see cases where an insurance company has denied paying a claim, even when someone has been paying premiums for years and relies on the insurance to protect them in a time of great need.
There are many different types of insurance and many reasons given by insurance companies to deny claims. Some of the reasons are listed below, but the list could go on and on.
Reasons Insurance Companies Deny Personal Injury Claims
･The claim was not reported promptly;
･The application for insurance was not truthful;
･The insured did not have permission to use a vehicle;
･Premiums were not paid as required; or
･If it's an uninsured motorist claim, the person seeking insurance did not reside with the insured.
Reasons Insurance Companies Deny Life Insurance Claims
･The application for insurance failed to list all medical treatment;
･The application was incomplete or not truthful; or
･The Lawsuit was not filed in a timely manner. – The insurance policy may require that a lawsuit be filed within a set time period, such as one-year. If it's not filed within that specified time frame, the Insurance company may deny a claim stating that the lawsuit was not timely filed.
Reasons Insurance Companies Deny Health Insurance Claims
･Claiming the treatment was “experimental” or unnecessary;
･Because of a technicality, such as a coding error or failure to get pre-approval;
･They claim the procedure wasn't covered under the plan; or
･The insured went to an out-of-network provider.
Reasons Insurance Companies Deny Homeowners Insurance
･The insurance company might try to say the damage happened over a period of time and not due to an immediate occurrence;
･That your premium is past due or unpaid;
･That your home wasn't properly maintained, thereby contributing to the loss; or
･They may claim the event was excluded on your policy.
Just because an insurance company has denied your claim doesn't mean you can't get fair compensation for your loss. Our Firm has seen all sorts of insurance claim denials, and we handle them all the time. Some of the cases we've handled include helping clients get life-saving cancer treatment that was previously denied, and helping clients recover on life insurance claims that were previously denied.
Insurance denials can be difficult to handle if you don't know the applicable federal and state laws and regulations. Insurance companies have a lot of available resources that you don't have easy access to. They may try to use this "one-sided" advantage against you, which can leave you feeling stressed and exhausted and wanting to give up. It can seem like insurance companies love to take premiums but hate to pay valid claims. If you've been denied insurance that you think you're entitled to then give us a call or contact us on our website. We'll review your case and tell you what we think. As always, our initial consultation is free and we only get paid if we recover money for you.