What you’ll learn from reading this article:
- What you are responsible for when making an insurance claim
- What your insurance company is responsible for when you make an insurance claim
- What rights you have if your claim is denied
There may come a time when you experience a slip and fall injury, a car accident, a work accident, a home theft, or property damage. “At least I have insurance,” you think. But then the rug is pulled out from underneath you when you read those dreaded words from the insurance company: “We regret to inform you that…” Do you have rights if your insurance claim is denied? Yes, you do, providing certain conditions apply:
- Your policy (the contract between you and the insurance company) must cover the damages that you are claiming. The good news is that if the wording is ambiguous, leading you to reasonably believe that you are covered for whichever contingency you are debating, the insurance company may be held responsible.
- You must have told the truth when you applied for your policy.
- You must report your accident, injury, theft, or damages within a certain time frame. Policies may differ on this time frame, so make sure to read your policy carefully when you first sign it. You don’t want any unpleasant surprises later on. To be on the safe side, always file your claim as soon as possible after an event.
- You must have proof that you were injured or that your property was damaged. This is why you should always phone the police if you are in a car accident, even if the damage seems minor at the time. You will need the police report. Always seek medical attention as soon as possible — for the same reason. Keep all receipts and documentation. You will need it.
- You must tell the truth when you make your claim. For example, if you exaggerate your injury or amount of damages, you can be denied, and in fact, you would be guilty of insurance fraud.
Now, suppose that all of these conditions are met. You have done everything correctly, but your insurance company is either denying your claim or delaying payment. In this case, the insurer is acting in bad faith. They are obligated to abide by the terms of the contract, so this is the point where you should consult an experienced attorney. (Click here for more information on common reasons why insurance companies deny accident claims.)
Some of the ways that insurance companies may fail to live up to their obligations are listed below: (You can read about them in more detail in the Indiana Code § 27-4-1-4.5)
- They may refuse to pay a claim where liability is reasonably clear.
- They may make an inadequate and delayed investigation into the claim.
- They may fail to approve or deny a claim within a reasonable or specified timeframe.
- They may deny the claim with little to no explanation.
- They may fail to defend you in a liability lawsuit where at least one of the claims is potentially covered by your liability policy.
- They may deny the claim based on an application misstatement after the period of contestability has passed.
You may be wondering what type of lawsuit you can file if your legitimate claim has been denied by your insurance company. Your insurance attorney will be able to determine this for you, but the most common types of lawsuits filed after insurance denial are:
Breach of contract: Your insurance policy is the contract.
Bad faith tort claim: Your insurance company would have had to act quite egregiously for this type of lawsuit to be recommended, but the law in Indiana states that your insurance company is required to deal with you honestly and fairly.
Unfair Trade Practices: If your insurance company used false advertising or other misleading tactics, these would be considered deceptive trade practices. State attorneys and private parties are allowed to file lawsuits against dishonest companies in Indiana. Although the state has not adopted the Uniform Deceptive Trade Practices Act, false and fraudulent advertisements are prohibited under Sections 24-5-0.5-3 and 35-43-5-3 of the Indiana Code.
As you can see, if your insurance company has denied your claim, you do have rights, but your course forward is complicated. You need an attorney who is well versed in Indiana law to advocate for you and get you the compensation you deserve.
Poynter & Bucheri Accident Recovery – Indianapolis Personal Injury Attorneys
If you or a loved one has been injured physically or mentally by a person, product, or company, you need to know your legal rights. Our personal injury attorneys are experienced with cases like yours and can evaluate what your case may be worth. We will ensure that you are protected and compensated for your injuries and losses. Why pay up to 40% in attorney fees? Our fee is only 25%, and we fight to win your case, or you pay no attorney fees at all. Don’t hesitate — one of our experienced attorneys can assist you right away. Call 1-800-265-9881 or contact us online for a free case review.