When an insurance company has denied payment on a claim, it is frequently difficult to know whether or not you have a case.
Over the past several years, insurance companies have become bigger, wealthier and more powerful and will frequently advertise that they have billions of dollars in assets. Insurance companies obtain that type of wealth by selling policies and collecting premiums, but minimizing payment of claims.
If your insurance company has delayed or denied payment of a claim or offered you pennies for every dollar owed, you may have a claim against them.
Insurance companies have a high duty of care to their insureds. Nevertheless, insurance companies engage in practices that result in wrongful denial of claims, including acts such as not responding to claims, searching for technicalities in the policy that give the insurance company a technical way of avoiding payment, and many times affirmatively breaching contracts or intentionally abusing their power to bully policy holders into taking what the insurance company is willing to pay as opposed to what a fair settlement of the claim would be.
Some examples of insurance disputes include:
- Disability Insurance. There are several technicalities that have to be followed before an insurance company will pay under a disability policy. Some policies have notice requirements that have to be met and there are many medical conditions that are exempted from the contracts. Frequently, clients will naively rely upon coverage under a disability policy without reviewing the terms of the policy. Moreover, the way some disability insurance policies are written inconsistencies between the medical community and the insurance company is unavoidable.
- Life Insurance Policies. There are many different types of life insurance policies. Many times an employer will provide a life insurance policy through a group health insurance plan which an employee may not know about. Some types of insurance policies have cash value and are called “whole life policies” other types of policies have no cash value and are called “term policies”. There are multiple ways life insurance benefits can wrongfully be denied. First, there can be issues as to whether adequate notice was given to the life insurance company. Second, there can be some forms of death, such as suicide, that may be excluded, and there are accidents occurring through certain types of employment and recreational activities that may not be covered. Frequently, an insurance company will make the unilateral decision to cancel a policy. This can happen when a policyholder is unhealthy or is getting older. Many times through a “clerical error,” an insurance company will cash the policy out, send the policy holder the cash or equity in the policy, and cancel the policy.
For elderly or unhealthy people who lose their insurance policies, it is virtually impossible to obtain life insurance, and if life insurance were to be obtained it would be much more expensive. Sometimes if the insurance policy holder has not been receiving yearly statements from the insurance company, the policyholder may not even know that the policy has been canceled.
- Health Insurance Policy Claims. Health Insurance is one of the most common types of insurance denial. Many times an insurance company will deny a health insurance claim taking the position that the charges were not “reasonable”. There also may be issues as to what is a deductible or covered charge. Sometimes an insurance company can authorize medical care or hospital care, but subsequently come back and deny such care and recoup money already paid to health care providers which can create huge amounts of medical bills for the insured.
- Accidental Death Policies. Many times accidental death policies will consist of several smaller policies. Often one policy will deny coverage on an accidental death while another policy will pay for the same exact incident.
- Bad Faith Insurance Claims. In Florida, an insurer has the responsibility to properly deal with its insured. Failure of the insurance company to abide by the terms and conditions of its contracted policy constitutes bad faith and can include denial of meritorious claims, failure to timely tender payment, and unreasonably low offers of settlement.
- Uninsured-Underinsured Motorist Coverage. It is the law in Florida that every driver maintains automobile insurance; however, many do not. Accordingly, it is public policy in Florida that every driver be able to purchase uninsured or underinsured motorist coverage in order to provide relief to innocent persons who were injured through the negligence of a motorist who was not insured. In the event that uninsured motorist coverage is not purchased, the named insured to the policy is required by law to have signed a written rejection of coverage. Frequently, insured persons will not have been advised as to their option to have purchased uninsured motorist coverage until they have been injured in a car accident and they find there is no insurance available to compensate them for their injuries.
Contact an Insurance Dispute Attorney
At the Moye Law Firm, we can handle the details of your insurance difficulties so that you can focus on more important issues: your health and your family. Tallahassee insurance dispute lawyer David Moye and his dedicated team of attorneys have the experience required and are prepared to represent you in a wide variety of disputes.
To learn more, call our offices at 850 224-6693 (224-MOYE).