HOW TO CONVERT DENIED INSURANCE CLAIMS INTO PAID CLAIMSAugust 23, 2016
Converting denied insurance claims into paid claims is possible if you have a clear understanding of your legal rights and the obligations of the insurance company. Follow these simple steps to force your insurance company to reopen your case and reconsider its denial to get your claim paid.
First, ask for a complete copy of your insurance policy so you may review your policy’s specific terms and conditions. Your insurance policy has a section which describes the “exclusions” from coverage and also the bases for which the insurance company can reject your claim such as excluded causes of damages, failure to pay premiums, failure to mitigate or protect property from further damage, or insufficient documentation of the damage.
Second, your insurance company must give you an unambiguous, specific reason explanation of the denial. You can immediately request a formal letter from the insurance company specifying why your claim was denied. This letter must include the section of your policy supporting the denial. You should follow up with your insurance company until you receive such letter.
Third, once you have the letter specifying the basis of the denial, you should compare the reasons for denial with the language they cited in your insurance policy. In the event the reasons stated by the insurance company are ambiguous or vague, you should request further clarification in writing from your insurance company and/or the insurance adjuster. You should document all conversations with dates, times, names, etc. You may need this information later.
If you have followed these steps and believe that your claim was wrongfully denied, you may seek an experienced insurance claim attorney who can help you navigate through your insurance policy, the insurance company´s acts and omissions in denying your claim, and your remedies under the Texas Insurance Code. The attorneys at the Amaro Law Firm have vast experience dealing with insurance companies. In fact, some of their attorneys worked as insurance company defense lawyers before joining the firm. Now they help property owners fight for fair and just treatment. Our consultations are free. If we cannot add value to your claim, we will not take your case. When an insurance company is found to have acted in bad faith, they are required to pay reasonable attorney’s fees. Therefore, we are only paid if we win. Contact us for a free claim evaluation.