In Denial
What do you do when your insurance company refuses to pay a claim?
Do insurance companies routinely deny valid claims just to avoid
paying for them? Such a scenario might make good dramatic fiction,
but it's not the case in the real world, says David W. Henry,
an attorney with Allen, Dyer, Doppelt, Milbrath & Gilchrist PA in
Orlando, Florida. "Carriers look to get the right
answer," Henry says. Even so, claims adjusters are human, some
claims and insurance policies are complex, and mistakes happen.
So what should you do when you think you have coverage and your
claim is denied? Henry, whose practice focuses on insurance
litigation, says to start with a written explanation from the
insurer. "Insurance companies normally provide this
automatically," he says, "but if they don't, insist
on it." You can also ask that a supervisor review the claim
decision.
Take the denial letter to your insurance agent and see whether
he agrees with the carrier's decision. "Sometimes, a
knowledgeable agent will know if the claims adjuster has made a
mistake," says Henry. If the agent agrees with the denial, and
you are satisfied with his explanation, the case is closed. If he
doesn't, he may contact the carrier on your behalf, or you may
decide to consult an attorney.
Content Continues Below
If it turns out your claim was denied because you didn't
have the coverage you thought you did, you may need to review your
policy and examine your relationship with your agent.
Jacquelyn Lynn is a freelance business writer in Orlando,
Florida.