After receiving an unfair settlement or claim denial, there are a variety of steps you can take to resolve the situation. Fortunately, insurance companies are contractually obligated to pay in “good faith” if your claim falls within the guidelines of your policy. If they don’t respect this agreement, there are legal actions you can take to ensure that your rights are respected (without going to court in most cases).
As long as you have met the conditions for fair and reasonable distribution, you and your claim will have solid ground to stand on. Of course, this assumes that your policy actually covers the damage you are requesting money for, and your claim was properly filed with supporting documentation. Unfortunately, even if you have done everything correctly, you may still be facing an underpayment or denial.
So, how can you overcome the insurance company’s hurdles if this is happening to you?
Have Your Documents Reviewed By A Professional
Since the insurance company will use any loophole or minuscule claim error to justify their underpayment or denial, it’s in your best interest to seek a policy and claim review. Our insurance adjuster in Pennsylvania will analyze your policy for free, and walk you through the next best steps you can take if you were wrongfully denied or underpaid.
Prepare & Contact Your Insurer
Organize all of your supporting documents, claim information, and have your policy nearby before you make the call. Your insurance company should have already sent you a letter stating why you were denied or underpaid; this is the first thing you should clarify when calling. Ask them if this denial information is correct, request that they review your claim again, and clearly outline why you feel that you were wrongfully denied. It’s also a good idea to record this conversation for additional supporting evidence if the representative provides you with false or misleading information regarding your claim.
Many times, a call to your insurance company will resolve the issue. Perhaps they overlooked a piece of evidence in your claim, or perhaps there was a billing error. It’s always better to affirm that the underpayment or denial was intentional before progressing to more expensive or time-consuming processes.
File An Appeal Properly
If you discover that your initial claim was improperly filed or lacks supporting documentation, you may need to file a claim appeal. This process is used to refute an underpayment or denial with a resubmission that better supports your initial request.
Since insurance companies have strict claim submission requirements and utilize their own appraisers to assess the damage, it’s in your best interest to seek the guidance of our public adjuster in Langhorne, PA. We provide professionally organized property appraisals, support and draft the entire appeal, and handle all of the negotiations with the insurance company on your behalf. Our processes prevent the need for litigation, protect your rights, and result in higher settlements in the majority of cases we support.
