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When you pay your home insurance premiums, you expect that your insurance company will be there for you when you need them most. But what happens if your Denver home insurance claim is denied?
Unfortunately, insurance companies often deny claims for a variety of reasons, some of which may be legitimate. However, in many cases, insurance companies deny claims unfairly or in bad faith.
If your home insurance claim has been denied, you have the right to appeal the decision and to consult with an experienced insurance lawyer. A Denver insurance lawyer can help you understand your rights and options, and can fight to get you the compensation you deserve.
Why Claims Get Denied
Claims can be denied for various reasons—some valid, others not so much. A few common reasons include:
Misinterpretation of Policy: Sometimes, the policy wording can be intricate and open to interpretation. Here, an insurance attorney can provide clarity and challenge any misinterpretations.
Insufficient Documentation: Insurance companies may need specific documents or proofs. Failing to provide these can lead to denials.
Lapsed Policy or Non-payment of Premiums: This is a straightforward reason. If you haven’t paid your premiums, the company may deny the claim.
Late Reporting: Timely notification of an incident or damage is crucial. A delay in reporting can often result in a claim denial as insurance companies might argue the delay compromised the ability to investigate.
Unintentional Non-Disclosure: Sometimes, policyholders might omit information when obtaining the policy, either because they forgot or deemed it insignificant. However, insurance companies might view this as a material non-disclosure and deny the claim.
Exclusions in the Policy: Every insurance policy comes with specific exclusions. If the damage or incident falls under these exclusions, the claim can be denied. An insurance attorney can help clarify these exclusions and ascertain if they were applied correctly.
Suspected Fraud or Misrepresentation: If the insurance company suspects that a claim is fraudulent or that there’s a misrepresentation of facts, they might deny the claim. In such cases, an insurance attorney plays a pivotal role in proving the legitimacy of the claim.
Wear and Tear or Improper Maintenance: Insurance typically doesn’t cover damage due to regular wear and tear or lack of maintenance. If the damage is deemed to be due to either, the claim might be denied. However, the line can be blurry, and an insurance attorney can argue on the exact cause of damage.
Not Meeting the Deductible: Some policies have deductibles, which means the policyholder needs to cover a portion of the loss. If the loss amount doesn’t meet the deductible, the insurance company won’t process the claim.
Claim Filed Under Wrong Policy: In cases where multiple policies or coverages exist, filing a claim under the wrong policy or section can lead to a denial. An insurance attorney can guide in ensuring claims are filed under the right policy or section.
Understanding Your Rights
If your home insurance claim is denied, it’s crucial to understand your rights. Below is a list of rights you have, backed by laws and regulations:
Right to a Written Explanation:
Insurance companies are required to provide a clear and comprehensive reason for the denial of any claim. Most states have insurance regulations mandating this.
Right to Appeal Internally:
You can challenge the denial by initiating an internal appeal where the insurance company reviews its decision.
Right to a Timely Decision:
Insurance companies are required to make decisions within a specific time frame. The National Association of Insurance Commissioners (NAIC) Model Laws set standards for timely claim handling, and many states have adopted similar regulations.
Right to Legal Action:
If all else fails, you can take the insurance company to court. This right allows policyholders to sue insurance companies for unjust claim denials. This right is generally protected under contract law and the insurance policy itself, which is a binding contract.
Right to Fair Treatment:
You have the right not to be mistreated, discriminated against, or to face unfair claim practices. Unfair Claims Settlement Practices Act, adopted in some form by many states, prohibits insurance companies from engaging in unfair claim practices.
Right to Full Policy Benefits:
If your claim is valid and within the policy’s scope, you have the right to the full benefits as per the policy terms. This is generally protected under contract law since the insurance policy is a legally binding agreement between the insurer and the insured.
Right to Know Policy Limitations and Exclusions:
You have a right to fully understand what your policy does and doesn’t cover. This right is embedded in consumer protection laws in many states, ensuring that consumers have all necessary information to make informed decisions.
Right to Representation:
You have the right to hire an attorney during any appeal or legal action. The U.S. legal system inherently protects this right for individuals seeking justice.
Why the Morgan Law Group?
With their vast experience spanning years in the industry, the Morgan Law Group has carved a niche for itself by offering unparalleled guidance in handling a range of insurance claims, from general home insurance to complex hurricane-related claims. Their team, known for its diverse knowledge, adopts a client-centric approach, ensuring each client is walked through every step, making them feel informed and comfortable.
The intricate maze of insurance claims, especially denials, demands the right knowledge and a proficient team. That’s where the Morgan Law Group steps in, offering the robust support needed to challenge and surmount these denials. If you find yourself disheartened by a denied claim, remember, the right action backed by a proficient insurance lawyer can make all the difference.
It’s time to assert your rights with the Morgan Law Group. Contact us today.
