What Should You Do After an Insurance Claim Denial in California?
You pay your insurance premiums every month for peace of mind, knowing that if anything goes wrong you won’t be left financially destitute because of it. At least, that’s how insurance is supposed to work. However, the bad faith insurance lawyers at DeWitt Algorri & Algorri know that a shocking amount of insurance providers have no issue denying completely valid claims.
Our team has a long history of handling successful insurance bad faith cases. In one, we secured $6 million for the family of an injured five-year-old. When pushed for compensation, the insurance company ignored the demand. In another, our team went up against an insurance company that refused to pay a claim for a victim who was left in a persistent vegetative state. Learn more about what do after an insurance claim denial, then call us at 855-WINNING to set up your own consultation.
Get More Information on the Denial
First, you’ll want more information on the denial. Your insurance provider must provide you with a concrete reason for the denial, but you could be left with a frustratingly vague answer. Keep in mind that insurance companies generally do the bare minimum that is legally required of them to discourage appeals. If the initial letter you receive isn’t clear enough, contact the company in writing to demand a more thorough list of reasons for the denial.
Review Your Policy and the Appeal Process
While insurance policies can be dense and wordy, spend some time going through yours for information on what is and is not covered. You will want to find anything specifically stating that a claim similar to yours is covered by the company. Additionally, the policy should have information on your right to appeal and how you can go about appealing your denial.
Going Through the Insurance Claim Appeals Process
Take note of the appeal deadline and begin the appeal process immediately. It can be time-consuming and require a lot of repetitive work, so you do not want to leave it to the last minute. Generally, you will need to send a letter to the insurance company telling them that you are appealing their denial and giving specific reasons that your claim should be paid out.
This part of the letter should directly relate to the denial reasons they gave you. For example, if they claim that the life insurance policy was canceled because of a missed payment, you can provide proof that every monthly payment was made on time. If they deny a health insurance claim because your care is not “medically necessary,” provide documentation from your doctor showing that the course of treatment is necessary for your care. You might appeal a denied home insurance clam by showing that the damage was not part of an exclusion condition in your policy.
Contact a Bad Faith Insurance Attorney
Ideally, the appeal process will be enough to secure a positive outcome for you. That isn’t always how it works, unfortunately. When an insurance company drags out an investigation, fails to investigate a claim at all, continues to deny a legitimate claim, or otherwise tries to deny you the coverage you have paid for, you may be the victim of insurance bad faith.
When this happens, you may need to bring in the California Department of Insurance and your own insurance bad faith attorney to litigate a wrongfully denied health, business or property insurance claim. Your attorney can bring their knowledge of the California Insurance Code to your case and fight for the compensation you are owed.
As a general rule, it’s better to loop in an attorney sooner rather than later. If an insurance company is intentionally working in bad faith, they simply won’t pay up until they are forced to do so. Hiring an attorney right away forces their hand and puts them in a position where they have to pay or risk a lawsuit. This saves you time and helps you get the money you’re entitled to more quickly. Try to choose an attorney with a solid history of bad faith cases behind them, as their experience may speed up the process for you.
Find Out How DeWitt Algorri & Algorri Can Help You
The team at DeWitt Algorri & Algorri is ready to hold your insurance company accountable for your wrongfully denied claim. Don’t wait any longer to get the money you deserve—you pay your insurance every month for reliable coverage, not flimsy denials and ignored demand letters. Start now by calling us at 855-WINNING or reaching out online.
Mark Algorri has successfully represented individuals and their families in matters involving serious and catastrophic injuries, insurance claims denials, and wrongful deaths, achieving a success rate of 99 percent for our clients.
