What should I do if my insurer refuses to pay a claim?
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What should I do if my insurer refuses to pay a claim?

On Behalf of | Sep 23, 2022 | Bad Faith Insurance

You buy insurance so that it is there when you need it. In most situations, you will pay for months and even years without ever making a claim. The insurer receives all your money, and you get no benefits until you have a claim.

Once you submit it to the insurer, you expect the insurer to pay it. After all, you have upheld your part of the deal by paying your premiums and deductible. But what happens if the insurer refuses to pay? Luckily, you do have some recourse, but there are a few steps to take before that.

Review your policy

CN  explains the biggest reason a company will deny your claim is that your policy does not cover the situation. So, make sure you read your policy and note where the coverage is for your particular situation. You need to arm yourself with this information to immediately refute the insurer’s claim that your policy does not cover this claim.

Appeal

Your next step is to appeal the decision. Gather your evidence and the policy papers so you can prove your insurance does cover your claim. If you cannot appeal or you get a denial for appeal, then you will need to escalate to the state and possibly the court. States do heavily regulate the insurance industry, so you may have some luck there. It is helpful if you understand insurance laws in the state and know what to expect as you move up in the process to find someone who can help you get the payout you deserve and to hold your insurer accountable for not paying out.