Purchasing insurance policies makes sense. You need them sometimes throughout your life. You’d hope you must never use your policy since that likely means something went wrong. However, if the unexpected does occur, you’ll feel glad you have that fallback.
There’s more than one tactic that insurance companies use to avoid paying claims, though. In fact, they have many excuses they might use if they feel like they can avoid paying off your claim.
We’ll talk about some of the most common ones now. You should know about these if you’re battling an insurance company following an injury or accident.
What Does It Mean When an Insurance Company Denies a Claim?
First, let’s ensure you understand what it means when an insurance company denies a claim. This is the most straightforward tactic an insurance company might use to avoid giving you any money, even if you have legal standing and should by all rights receive a payout.
If an insurance company denies your claim, they might do so because they say you don’t need a procedure, even when a doctor says you do. For instance, maybe you have a health insurance policy.
Your doctor says you need surgery because you have a chronic condition. It won’t get better without that procedure.
When you tell your insurance company you need that operation, their representatives claim you don’t. They might have medical professionals who dispute what your doctor says.
The medical professionals who work for insurance companies can have some unscrupulous tendencies, though. They’re not looking after you like you’d expect from your own doctor. Instead, they’re saving the insurance company money. That’s their sole motivation.
The insurance company might also claim you’re defrauding them. They may also use technical language in your insurance policy if they feel like it lets them off the hook.
No matter what they tell you, denying a claim probably means you must hire a competent lawyer and battle the insurance company in court. Maybe they’ll relent if you tell them that you have legal representation. The company will often do all it can to prevent paying for a medical necessity, though.
Lowball Settlement Offers
You might also expect a lowball settlement offer. Maybe you have a valid legal claim and should expect some money. The insurance company can’t dispute that. They might feel they can buy you off with a smaller amount, though.
This might happen in several scenarios. For instance, let’s say you’re driving on the highway, and a commercial truck hits you and runs you off the road. The trucking company has insurance, and the policy should cover your pain and suffering from your injuries, your damaged car, and the wages you’ve lost while you’re recuperating.
That insurance company might offer you a settlement, but it’s nowhere near the amount you need. It’s a small figure that won’t cover your lost wages, medical bills, and so forth.
The insurance company might think that they can buy you off with that small amount because you’re desperate and you need that money. They may also feel that you don’t know your claim’s actual value.
In some cases, they’re right. They’ll encounter someone who doesn’t realize their claim’s true value, or maybe you just need money so badly you’ll take the first amount they offer, not understanding you can fight them in court.
You can always turn down that settlement, though. If you get a skilled attorney who can counter that offer or threaten a court case, the insurance company might change their tune. They might offer more, or they may say they’ll pursue the matter in court. In that instance, your lawyer must help you.
The Insurance Company Might Drag Their Feet
Some insurance companies use another tactic if they feel they can avoid paying you. They might say they’ll get you your money, but they’ll delay and use stalling tactics for as long as they can.
They know they must pay eventually, but they’ll drag out the process for weeks or months. They might do so thinking that you’ll subsequently accept a smaller amount just to get anything at all.
Stalling usually has questionable legal arguments behind it. Once again, having a savvy lawyer who knows these delaying tactics can help you. They can apply pressure and force a payment, usually for the full amount.
Blaming the Victim
You might also have a situation where the insurance company reviews the case’s facts and feels like they can blame you, the victim. They might produce a witness who says things happened differently from what you say. Maybe they’ll use junk science and dispute your claim that way.
That’s shameful behavior, but some insurance companies have no problems doing that if they feel like they can get away with it. If you hire the right lawyer, they can stand up for you and defend you against these spurious accusations. They can present their own evidence in court if things ever progress that far.
Insurance companies blaming victims can make you feel awful. You know you did nothing wrong, and someone else caused your illness or injury. You must prove it, though, and only a skilled attorney has that ability.
You probably see a commonality with all of these cases. In each instance, getting the right lawyer helps you combat the insurance company and their underhanded tactics.
Remember that when you’re dealing with an insurance company, that’s a for-profit entity. They don’t like giving away any settlement money unless they feel they have no other choice.
That means they’ll use any strategy possible to avoid paying you, and if they must pay, they’ll try giving you a smaller amount. This way, they can save as much money as possible, and their CEOs and other high-placed employees can collect hefty bonuses.
You can fight back, though, and in some cases, you must. Make sure you get the money you deserve with a lawyer who can challenge any insurance company’s assertion.
