Every year the National Association of Insurance Commissioner’s office gets flooded by the letters of insurers complaining against their insurance companies for not paying them. This is a common scenario in all over the world. Everywhere the insurance company is looking for an excuse not to pay you or not paying the amount you are entitled to. So if you have been refused by an insurance company or you feel like you have been defrauded by them you can do a lot. Here are a few steps on what to do when your insurance company won’t pay.
12 Things to do When Your Insurance Company Won’t Pay?
#1. First “no” is not final
More than half of all the insurance claims are denied by showing some fault but less than one percent of the customers ask the insurance company why their claim was denied. So the insurance company escapes in most of the cases.
But the customers who do contest their cases either win their cases or get higher settlements. So taking no as an answer is not a wise decision if your facts are right.
2. Ask for written explanation:
Almost every state in the U.S. has a law that states that every insurance company should give it in writing, why they are rejecting the claims of the insurer. So if the company fails to give you a written complaint then you can take legal action against the company.
#3. Know every clause of your policy:
Suppose the insurance company interpreted a clause in a different manner and you have understood it differently. So don’t get panicked. If the ruling doesn’t sound fair to you maybe there is a good chance that you are right in that case. Don’t believe everything they say. Use your sense of fairness.
#4. Filing errors can’t reject the policy:
When you are filing for the claim you should always follow the instruction given by the insurance company. But if you have done some mistake while filling the form or you have missed the deadline for submitting a claim. Then an insurance company cannot refuse to pay until and unless the company can show it has been harmed by your error or failed to investigate due to your delay.
#5.Do proper research:
If you think the insurance company has paid less than you have calculated then check with the other institute who does a similar type of work. If other institutes charge more than you have received then you should challenge the payment that you have received. There is a chance that you can get a higher settlement.
#6. Ask for agents help:
The agent from whom you have purchased the policy is bound to help you so that you can get as much coverage as you are entitled to. It is his duty. So you should contact your agent if your interest hasn’t met as you have thought it will.
#7. Directly contact with the insurance company:
If your problem is not being resolved within 30 days by the insurance agent or the claims administrator then you should call the insurance company directly. During the telephonic conversation, you should be polite but persistent. You should record the calls that you make. You should also note down the name and the post of the persons with whom you are speaking. Save your phone bills that list the calls. With each call write a letter to the insurance company what you have understood from the conversation and request a response time within 30 days.
#8. A complaint in writing:
If the telephonic conversation is not working then it is time for you to write a complaint letter. Start with the person who first denied your claim. After that write a letter to his supervisor. In the letter give your policy number details, all the relevant forms, bills as supporting documents. In the letter explain the negative effects, you are facing due to the denial of your claim. The letter should be unemotional and you should avoid rude and blaming statements. Give them 3 weeks’ time to respond. Send this letter through a registered mail.
#9. Write a follow-up letter:
If you don’t get any reply from the insurance company then write a follow-up letter with your original letter attached to the customer complaints and the company president. In most states of the U.S., it is unlawful not answering the letters. So it will be regarded as the insurance companies fault.
#10. Take outside help:
If it is necessary take help from outside. To add pressure you should take help from the
- State Department of Insurance. It is free and they will mediate your dispute.
- Professional arbitrator.
- A lawyer.
#11.Get assistance from a professional:
If you hire a lawyer you will have a better chance to successfully challenge a claim.
#12. Look for violation:
If your claim is denied due to a reduction in coverage. Then first check if they have notified you earlier about this reduction.
If you were not informed then you have a good chance of winning your claim. Because the insurance company had failed to inform you about the reduction it will be considered as a violation of the law.
So it is better for you to do background research of the insurance company before you take up any policy. Having an attorney when the insurance firm interviews you to get the details about the claim can be a good idea. It is also important to know your rights in case of any dispute. Taking an insurance company to the court can be a risky job as you can get stuck for many years.
There are many insurance companies in the market with different types of policies with different types of features. So you should check all the policies before taking one. Taking advice from a financial advisor is always a good choice. Choose the policies according to your need. Read the policy and talk to the agent to be sure about the coverage and the cost. Don’t purchase any policy until and unless you are sure about it.
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