Foshee & Yaffe
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Insurance Coverage Denials

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You may have an insurance policy, but that is not a guarantee that you will have a smooth experience in filing a claim and getting the compensation you need and expect. A denial for claims can and does happen regularly in Oklahoma. Some denials are based on sound reasoning, but others can really catch you off-guard and leave you wondering what next? Below are a few of the most common reasons for insurance coverage claim denials that our local lawyers have experienced.

LACK OF INSURANCE COVERAGE

You may feel that you have coverage for certain things, such as floods in your home and long-term disability, but you may find (at the worst possible time) that you are not covered. Always carefully look over your policies to know what you do and do not actually have. It will save the embarrassment and aggravation of a future claims denial.

FRAUDULENT CLAIMS

Never over-exaggerate your claim. If it can be found that you are being less than honest about any situation, it can bring about a claims denial. It can make it difficult to get further insurance coverage.

NOT FOLLOWING STIPULATIONS

Some policies state exact stipulations that will make or break whether you will get a claim approved or denied. An example of this is if you have a standard auto liability insurance policy and you let an unlicensed driver use your vehicle. If damages arise from your allowing someone not legally allowed to be behind the wheel then you will find any claims that come forth denied.

NOT DISCLOSING DAMAGES OR INCIDENTS

You need to document and report incidences and damages so that your insurance company is not caught unaware. For instance, if someone gets hurt on your property, then you need to report it to your home insurer before they find out from litigation. Failure to do this can cause a denial of a claim, and then you are in for paying the damages yourself.

IGNORING OR DRAGGING OUT CLAIMS

Having your claim sit idle and ignored is another way that leaves your situation in limbo. There are times that an insurer will simply refuse to deal with a claim. It seems an unfair way to do business, and it does need to be dealt with legally. Don’t let yourself become a victim of malpractice insurance in Oklahoma City – stay on top of your insurance claim!

WHAT NEEDS TO HAPPEN

If you received a denial of an insurance claim and it is valid, you have coverage and you have followed all stipulations and reporting procedures, then you need to file an appeal. It will be required, whether it changes the claim status or not. Make sure to document everything as you go along. The better your documentation is the stronger your case is.

HOW INSURANCE LAWYERS AT FOSHEE & YAFFE CAN HELP

You also need to discuss your situation with an attorney that is qualified to understand insurance law. They can help intercede in situations and help you come to settlements outside of court but are also able to help build and carry out a lawsuit if it necessary. Never take the claim denial by an insurer as the last word on the matter.

BREACH OF CONTRACT

If you have the coverage and you have a legitimate claim, then it is wrong to be denied. It is a breach of contract and suit can be brought against the carrier to get you the remedy you need. It is typically only the amount of coverage and maybe attorney fees.

BAD FAITH OR MALPRACTICE INSURANCE IN OKLAHOMA CITY

A bad faith claim can be brought against a carrier that creates purposeful neglect and harm to your case. This happens in cases of flagrant ignoring and dragging out your claim. You can often recover pain, suffering, and stress damages when it is found to be an act of bad faith.

If you feel you have a legitimate claim and have been denied, then you need to seek good and accurate legal consultation. The law is not always as cut and dry as the claims denial will lead you to believe. Insurance companies are going to do everything they can to save money. You need to do everything you can to make sure that you have been given a fair chance to get the compensation needed. Contact us today to get started!

 

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