When you regularly pay an insurance company, you expect that coverage will be provided when you need it, and being denied it can be shocking and stressful. Here is what to do if your insurer is refusing to pay your personal injury claim.
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Determine Whether the Denial is Wrongful
If there is no legitimate reason for your insurance company to deny payment on your claim, it is considered an act of bad faith. Ask your insurer for a detailed explanation of why your claim was denied. Signs of a wrongful denial will typically be a lack of reasonable explanation or details on how they came to that decision. Find out exactly why the company denied your claim then review all of the documentation you submitted. If you have solid evidence that their reasoning is unexplainable, your claim denial may be wrongful. Some other signs of bad faith tactics by an insurance company include:
Inadequate or delayed investigation into your claim before the denial.
Refusing or delaying payment even when there is clear evidence of liability.
Failing to approve or deny a claim within a reasonable amount of time.
Denying a claim after the contestability period has passed, on the grounds of misrepresentation.
Texas has laws against bad faith tactics to protect policyholders, but insurance companies still engage in unfair or deceptive business practices.
Speak to an Attorney
Acting in bad faith saves an insurer money, and they assume that you will not fight back. After they wrongfully refuse to pay on a valid claim, speak to a Houston Personal Injury Lawyer as soon as possible. They will review your claim closely to discover why it was denied. If they determine your insurance company made a mistake or is acting in bad faith, they can help you file an appeal or a bad faith insurance lawsuit. In some cases, hiring an attorney and notifying the insurance company of your intent to appeal or sue is enough motivation for them to settle your case.
Common Reasons for Valid Personal Injury Claim Denials
Common reasons for valid personal injury claim denials include the following:
Failing to file your claim on time. The time limits vary in Texas, depending on the nature of your claim.
Missing or incorrect information on your claim form.
Your condition does not meet the definition set by the policy.
The policy does not cover the nature or location of the accident.
The insurance policy has lapsed or was not in effect at the time of the accident.
Lack of medical evidence.
The injury is a pre-existing condition.
You failed to prove that the insured caused the accident.
Video surveillance and social media conflict with your story.
The person who caused the accident is not covered by the insurance policy.
Contact a Lawyer for Help
A Houston personal injury attorney can help ensure you recover the compensation you deserve. Call Ramsey Law PC at (888) 335-7477 to arrange a free consultation today.