Fighting Insurance Companies that Continue to Deny in Record Numbers
By Space Coast Daily // December 30, 2018
Few people actually believe that insurance companies have their clients’ best interest in mind.
Insurance companies are in the business of promising-making, charging consumers for a service that exists mostly in theory, and then finding creative ways to deny legitimate claims.
The reality is, more claims are denied than approved. This means that regular Americans who are doing things by the book actually have to sharpen their claws to ensure that the insurance company honors its commitments.
However, insurance companies keep on staff well-trained mitigating attorneys who are ready to fight for them tooth and nail at a drop of a dime. It’s not suggested for anyone to go head-to-head with an insurance company without professional help.
Why are so Many Claims Denied?
On paper, the idea of paying a monthly installment to a company that promises a certain amount of coverage in the event of an accident, a mishap, an illness, among other things seems like a wise and responsible thing to do.
Americans who pay for insurance take on these monthly payments in good faith. Insurance companies work hard to gain the trust of their clients using charismatic salespeople and good advertising, but it seems like they continually fall short of their promises.
Money is the primary reason for any successful denial of a claim. Whether it be life, auto, home, or any other policy, those monthly payments are being collected and applied to various investments.
In other words, they’re using your money (which is free money for them) and pouring it into investments such as real estate, commodities, derivatives, and other investments in the hopes of making a 100 percent free profit.
When an insured person files a claim, the insurance company must now dip into a cash reserve that doesn’t even include what the insured has been paying in monthly premiums. Thus, rather than the money used for investment be a risk for the insurance company, the insured is the risk.
This explains why insurance companies today conduct “risk assessments” of potential clients.
On top of that, the contracts are purposefully crafted in a way that the average person won’t understand it nor is interested in trying. Therefore, most clients flip through the inch thick contract, signing where ever asked without ever reading a line.
These companies then hire adept personnel to help them find loopholes or mistakes when the insurance was purchased or when a claim is made. These individuals use these mistakes or loopholes to deny claims, which happens often.
This may be a hard pill to swallow, especially for those who have been paying insurance premiums for years or even decades in some cases. But it’s important to understand this and prepare for a fight.
According to the Law Office of Matthew L. Sharp “when an insurance company acts in bad faith and fails to comply with their duty of good faith and fair dealing, the policyholders may be entitled to financial compensation for the damages caused by the bad faith conduct.
A claimant should never enter a courtroom or meet with any insurance company representative without first retaining an attorney who has experience helping clients get what’s owed them from the insurance companies.
How can People Fight Denials?
Well, one way to do this is to hire experienced representation, but there is much more that can be done. One example is to learn all the tactics insurance companies use to deny claims, the first being taking advantage of those who didn’t read the contract they signed.
Perhaps one of the most commonly used tricks that insurance companies use has to do with the way the claim is made.
Insurance companies deny people for filing incorrect paperwork or because they didn’t submit all the required information by a specific time limit. There are some insurers that go as far as to find a reason to deny a claim simply because the paperwork was not submitted in the order specified by the company.
Keep in mind that some of these rules are hidden in large booklets of information that are nearly impossible to decipher – this is done to confuse clients. For this reason, claims should be made with the help of a professional.
Another trick that insurance companies use is questioning fault.
When an insurance company doesn’t intend to pay out claims, it’s common for their “investigators” to say the incident was caused by the person filing the claim.
For example, an auto insurance company may argue that the insured is partly or entirely at fault, despite police reports stating otherwise. These investigators don’t hold any value to even the sworn statements of police officers unless those statements help the company get out of paying the settlement.
Insurance companies who deal with injuries may also hire medical professionals to help examine the policy owner with the sole purpose of finding a way to deny the claim. The doctor may try to minimize the seriousness of the injury sustained or may deny that it happened due to the accident.
Having the word of a medical professional on the side of the insurance company can make it hard for a person to rightfully claim his or her coverage. An experienced lawyer should be able to provide an independent medical examiner to ensure that the results from the examination are unbiased.
Americans hoping to get their expenses covered need to make sure they understand that it is an uphill battle. It would be nice to say that all insurance companies are doing their best to take care of claims of deserving people, but things don’t always work out like that.
Those who intend on fighting claim denials need to understand that patience is the name of the game, so be ready.
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