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Should I Make An Insurance Claim?

"I bought the policy, paid the premiums for years, filed the claim and now the insurance company doesn't want to pay! What do I do?"

We've heard this same story all too often. Whether it's auto insurance, homeowners, disability, health, or life, the problems we encounter are similar, ranging from a simple misunderstanding to intentional and outrageous conduct on the part of the insurance company.

But you do have certain rights under the law. An insurance policy is a contract between the insurance company and the policy holder. Oftentimes the policy protects others, generally called beneficiaries, in addition to the policy holder.

Both parties to a contract will be required to live up to the terms of the contract. For this reason, it is the actual policy of insurance which becomes the center of attention. If an insurance company fails to pay your claim, the first thing to do is to get a copy of the policy and review it carefully. If you don't already have a copy, request one from your agent or directly from the insurance company. If they seem at all reluctant, place your request in writing and mail it by certified mail, return receipt requested.

An insurance company must pay claims within a reasonable amount of time after the claim, with the necessary supporting documentation, has been submitted.

Even if the company is disputing a portion of the claim, they must go ahead and pay promptly the undisputed portion of the claim.

If your claim is denied, you may be entitled to an appeal of the denial, arbitration, or to bring suit against the company. Again, this depends upon the type of insurance involved and the language of your particular policy. In some instances the time limits within which you must act are very short. For instance, with a claim for health care benefits filed under a federal law called ERISA, your appeal must be filed within 60 days after you receive notice that the claim has been denied. In other situations the time periods are substantially longer.

If you feel that you are being abused by your own insurance company, and can't get the problem resolved on your own, we will be glad to discuss your problem with you in a free initial consultation.

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