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Submission of an insurance claim is the most obvious option, but what if that claim were to be denied?
Possible reasons for such a denial
• Terms in policy do not include the type of accident reported
• The claimant’s name does not appear in the policy
• The damaged vehicle has not been mentioned in the policy
• The policy has expired.
• The value of the claim is greater than the stated limits on the policy
• The observed damage is unrelated to the accident
• The location and nature of the damage does not match with the story provided by the claimant.
• The report of the accident was not provided in a timely manner, or was not provided by using the proper channels.
How response to denial of claim could aid utilization of a different option
Ask for a written explanation, if the adjuster has failed to provide one: If no response to letter, that fact could be used as basis for “bad faith” lawsuit (read following section).
Go after more evidence, in support of your claims: Such evidence might be found in video footage, or in a medical observation that got overlooked by the adjuster.
Request an appraisal of the adjuster’s decision, or request an appeal. Send notice to the State Department of Insurance.
Consult with a Personal Injury Lawyer in Barrie; claimant might be able to sue the insurance company for “bad faith.” If lawyer were able to win such a lawsuit, then the insurance company would have to honor the submitted claim.
What actions might indicate to a lawyer that the insurance company could be charged with “bad faith”?
• The insurance company chose to deny a legitimate claim. Policyholders pay for access to coverage, or for legal support if held liable for accident.
• The insurer had not called for the expected investigation of the claim. In other words, the denial did not have a sound basis.
• Denial not accompanied by an explanation; none provided in response to request for same document.
Every state has a specific claims process. The state’s Department of Insurance could check to see if the claims process had been followed properly. An insurance company would have not have the right to deny a claim, if it had failed to follow the procedures that had been laid down by the state government.
Claimants have a right to know any information that could affect their claim. If the insurance company had gained access to certain information, but had not shared it with the claimant, then that could be grounds for a “bad faith” lawsuit. By the same token, if it had kept such information hidden from the claimant’s lawyer, then that, too, would support a charge of “bad faith,” one targeted at the insurer.