Having to file an insurance claim after a disaster is a tense and stressful situation. Having that claim denied can feel like a kick when you’re already down. It might seem easier to give up, but most of the time, that isn’t an option. Insurance companies profit off denied claims and lowball settlements. They don’t often act in good faith, and you should fight for your claim. Here’s what to do.
Prepare for Battle
The first step to any action, take a long deep breath. Afterward, you need to take a comprehensive look at your policy. It is a written contract between you and your insurance company of what they cover. Quickly skim and outline any clauses and definitions pertaining to your claim. Also, write down any exclusions, limitations, or conditions that might have been applied to your case.
Read the language used carefully and look for important words such as “always,” “never,” “and,” “or.” A requirement for you to do X “and” Y is not the same as you doing X “or” Y. Lastly, look at the section in your policy on creating an appeal.
GatherDocumentation
These are the most important tools and resources in a dispute. At a minimum, you should get a denial letter from your insurer and create a list of questions about the denial. You should also provide any photos and records that support your situation. After that, contact the insurance company to ascertain why the claim was denied. During the call, make sure to have a pen and paper to take notes and perform the following actions.
- Be straightforward and ask the person on the line why the claim was denied. After explaining your reasoning for why you assumed you had coverage, ask politely for an explanation on why that reasoning was considered invalid.
- Get the name of the person you are talking to and write down the date and time of the conversation. Ask them for a phone extension in case you need to reach them.
- Ask them to check for any clerical errors; sometimes, the process ends here. If this isn’t the case, move onto the next step.
Start an Appeal
Most appeals start with sending a letter to your insurance company asking them to reconsider your claim. This is where your preparation comes into play. Try to lead with the implications of why your claim was denied, and counter it with details on why you think the policy should cover it. Include a copy of any records or evidence that you’ve gathered, keep the originals. If you have any difficulty writing a letter, you can always go to a professional. Be aware; appeals have to follow a strict timeline. Make sure that neither you nor your insurer miss any deadlines. If your appeal is successful, congratulations. If your appeal is denied, it’s time for the last step.
Call in the Calvalry.
It’s time to contact our law firm for a case review. We’re professionals, and we deal with thousands of cases a year. We’ll go over your policy and review your case. If we can help, we’ll negotiate with your insurance company on your behalf.