Facing insurance disputes can be challenging. As a policyholder, you may have experienced a difficult event, such as an accident at work, a car accident, or a natural disaster that damaged your property. When insurance companies wrongly deny or delay payouts in claims. Understanding your coverage and hiring an attorney can help you navigate the complex legal landscape to pursue a fair settlement when insurance disputes arise.
Jones Gregg Creehan Gerace has extensive experience representing insured parties and insurance companies in various insurance dispute cases. Our Pittsburgh attorneys have an in-depth understanding of Pennsylvania insurance laws and extensive experience negotiating a successful outcome.
Types of Insurance Disputes Cases We Handle
An insurance claim dispute occurs when the insurance company and the policyholder cannot agree on a settlement. Insurance disputes can occur with health, life, dental, homeowners, and auto insurance. Additionally, disputes related to workers’ compensation insurance can occur.
Many insurance disputes arise when the insurance company refuses to pay a settlement, delays payment without an explanation, or offers less than the policyholder’s claims. Insurance disputes may arise due to the following types of disagreements:
- Denial of coverage of claims
- Nonpayment or underpayment of benefits
- Wrongful policy cancellations
- Disagreements over increases in premiums
- Perceived misinformation from the insurance company
- Disagreements over changing policy coverage
- Misunderstanding the tax benefits or discount after purchasing insurance coverage
- Lapse in coverage without notification
- Forged signatures or other fraudulent conduct
What Will Happen if You Have an Insurance Claim Dispute?
When a policyholder files an insurance claim, the insurance company has three options. They can pay the amount requested as part of the policyholder’s insurance policies and coverage. The insurance provider can refuse any claim payments or offer to pay the policyholder a lower amount of money, also known as a low settlement offer. The first two scenarios can lead to a claim dispute.
Disputes Related to Health Insurance Denials
When an insurance company denies a claim, the insurance company must provide a reason for the denial. If the policyholder believes the reason for the denial was in error, the policyholder has the right to file an appeal to have the claim reassessed.
At that point, if the insurance company still doesn’t approve the claim or the policyholder believes the insurance company acted in bad faith, the policyholder should contact an attorney for legal representation. Insurance companies commonly provide the following reasons for denying insurance claims, including the following:
- The terms of the insurance policy exclude coverage for the claim, which may have been misunderstood
- There was a lapse in insurance coverage during the time period specified in the insurance claim
- Incomplete or incorrect information within the insurance claim
Resolving Insurance Disputes Related to the Denial of Claims
The attorneys at Jones Gregg Creehan Gerace have extensive experience representing clients in insurance disputes. We will work with you to resolve the dispute out-of-court to avoid costly litigation. In some cases, insurance disputes can be resolved by filing an appeal to the denial of the claim.
If your insurance claim was wrongly denied, we will notify the insurance company and handle all communication. The case may proceed to court if the dispute can’t be resolved by filing an appeal or speaking to an insurance representative.
Insurance disputes are generally complex and require an in-depth and well-rounded knowledge of legal and technical details that may be relevant to resolving the dispute. Working with an attorney who can review your case and provide you with an effective legal strategy for resolving the insurance dispute.
Insurance Disputes Related to Natural Disasters
In the case of a natural disaster, policyholders need to go through the same process for filing a claim and obtaining compensation. Insurance companies will likely need to process hundreds or thousands of claims simultaneously from everyone impacted by the disaster. Insurance companies generally designate all cases to a dedicated claims manager in these situations. State-level insurance departments usually set a deadline for the company to acknowledge all claims, typically within 15 days.
Bad Faith Insurance Disputes
Insurance companies can face severe penalties through civil lawsuits or regulatory bodies when they engage in deception or fraud. There are several ways bad faith insurance disputes can arise. When an insurer denies all or part of a valid insurance claim, refuses to pay a valid claim for an extended period, or tries to lay the burden of proof only on the insured, the insured may have a valid bad-faith insurance claim. The insured party must prove that the insurance company knowingly acted unreasonably in processing, responding to, or paying the insurance claim.
Jones Gregg Creehan Gerace is prepared to advocate for the coverage you deserve. If insurance has failed to act in good faith toward you, you can pursue damages from the insurance company. Victims of bad faith insurance companies can pursue damages, including the amount of insurance the company should have paid with interest, attorneys’ fees and court costs, and other punitive damages.
What To Do If You Have an Insurance Dispute
Insurance disputes can happen even when the policyholder does everything right. If you’re involved in an insurance dispute, taking notes after discussions with the insurance company is important. If there were any witnesses to the accident or natural disaster, write down their contact information. Gather any necessary evidence, including communication with the insurance company. This documentation will help you protect your legal rights and prove your legal claim.
You should also file a claim with an insurance provider that includes all the facts about the event and proof of any damages you’ve incurred, such as medical bills for treatment. Resolving insurance disputes can be complicated and take a long time. Working with an experienced attorney can help you understand your legal rights.
Discuss Your Insurance Claim Dispute Case with a Skilled Attorney
Jones Gregg Creehan Gerace has a proven track record of advocating for policyholders in insurance disputes. Our insurance attorneys also represent insurance companies in disputes. Don’t hesitate to contact Jones Gregg Creehan Gerace to schedule an initial consultation and learn more about how we can advocate for you.