While suffering personal injuries is a traumatizing experience, having your compensation claim denied amplifies your stress and financial burden. Ideally, having an insurance cover should protect you from the financial burden of unexpected accidents. However, the insurance company can deny your compensation claim for various reasons.
It is normal to feel confused and helpless if the company denies coverage, especially if you have been paying premiums for years. Fortunately, the denial of the compensation claim isn’t the end. With the help of experienced lawyers from Schuerger Shunnarah Law firm, you can appeal your claim and possibly sue the insurance company for denied claims.
When Can an Insurance Company Deny Your Claim?
Your insurance company can deny your compensation claims for various reasons. They include:
- If the insurance coverage lapsed or you haven’t paid premiums
- If you filed a claim that isn’t covered by your insurance policy. For example, most auto insurance policies only cover the person named in the policy. This means the policy won’t be valid if someone else was driving your vehicle.
- If you provide false information when purchasing the policy or filing the compensation claim.
- You exceeded the statute of limitations
- If the insurer finds you are liable for the accident
- If there’s a dispute on the extent of your injuries or damages.
Insurance companies typically dispatch insurance adjusters to evaluate your claim before accepting or denying it. The adjuster will inspect the injuries and review the proofs available to determine the amount of your payout if you are eligible.
When Can You Sue the Insurance Company?
Finding out that your claim has been rejected is certainly devastating. However, you can explore other options. You should start by appealing the insurance company’s decision. If the insurance company isn’t willing to reconsider or review their decision, you should file a lawsuit. You can sue your insurance company for the following reasons:
1. Breach of Contract
Purchasing an insurance policy essentially means you’ve entered a legally binding contract with the insurance company. As per the contract, the insurance company should compensate you for personal injuries and property damage in case of an accident. Denial of a valid personal injury claim constitutes a breach of contract.
Rejecting your insurance claim without a solid reason means the insurance company has breached the contract. You should work with a personal injury attorney to launch your case against the company. You’ll be eligible for compensation for the personal injury and damages from wrongful denial if you win a breach of contract lawsuit.
2. Bad Faith Conduct
You can also sue your insurance company for acting in bad faith. Simply put, this means suing the insurer for failing to handle your personal injury claim fairly or violating the duty of good faith it owes to policyholders. As with the breach of contract lawsuit, the insurance company will have to pay for the compensation and a penalty for acting in bad faith.
Endnote
While you can sue your insurer for denied claims, you shouldn’t rush into it. You should request an appeal, collect evidence, and present your case for review. You can also request an external review from relevant agencies. Proceed with the lawsuit if both options fail and you are certain of your case.
