What to do if the insurance company denies your claim?

At some point, each of us has to deal with an insurance company.

In other words, we all have some or the other insurance policy. The insurance company is responsible for dealing fairly with their customers when there is a claim. However, there are times when insurance companies tend to act in your best interest.

The situation when an insurance company is trying to settle your claim unfairly is called a case of “Bad faith.

In such situations, as a customer, you have all the right to sue the insurance company for bad faith.

However, to avail this right, you need to understand the cases/situations defined as “bad faith.”

The Situations:

1. Denying a claim amount:

Every insurance company should provide a valid reason for denying a claim amount. However, if you realize that the insurance company’s reason for the denial of the claim amount is not valid, you have all the right to file a case of bad faith.

The case would make the insurance either justify the denial or let you win your worth.

 

2. Offering less money:

We take an insurance policy as monetary coverage for unexpected incidents. Therefore, if you realize that the insurance company is quoting a lower claim amount, you have all the right to sue the insurance company for bad faith.

 

3. Failure of prompt investigation:

Insurance companies that wish to dodge the settlements are not prompt at investigating the incident, victim, and losses. Such a situation also falls into the category of bad faith.

 

4. Delaying the process:

If your insurance company is intentionally delaying the claim process or avoiding prompt response to your claim, you can sue the insurance company for bad faith.

Every state has a mandatory time limit for settling insurance claims. If you realize that your insurance company is delaying or violating the time limit, it is bad faith.

 

Now comes the question, how to sue the insurance company?

You must file a valid Civil Remedy Notice (“CRN”) first. The Florida Department of Financial Services (“DFS”) provides the available form, which can be filled out online.

You would need the following details while filling out the form:

  1. Complainant’s Name;
  2. Complainant’s Address;
  3. Complainant’s E-mail address;
  4. Complainant type (the policyholder (“Insured”) or some other person);
  5. Insured’s Name;
  6. Insurance Policy Number;
  7. Insurance Claim Number;
  8. Attorney’s Name;
  9. Attorney’s Address;
  10. Attorney’s E-mail Address;
  11. Type of Insurer (authorized or otherwise);
  12. Name of Insurer (selected from a drop-down menu)
  13. Address of Insurer (should be included in the narrative);
  14. Type of Insurance (Commercial, Residential, or otherwise, selected from a drop-down menu); and
  15. Reason for Notice (selected from a drop-down menu, typically includes Claim Delay or Claim Denial).

 

Once you file the claim, the insurance company will try to prove the claim wrong. 

Therefore, it is suggested that you have an attorney who would take the lead and fight the case vigorously.

He would know the proper documentation process to help you win your case.
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