Denied Insurance Claims

When presented with a claim, an insurer has the obligation to investigate the claim promptly and either to pay the claim or to deny it.

As to liability defense coverage, when an insurer is presented with a pre-suit claim or request for defense coverage, an insurer generally has three options: defend, deny coverage and refuse to defend, or defend under a reservation of rights and seek a declaratory judgment, if necessary. Individuals and businesses that have paid insurance premiums faithfully for years can sometimes be told by the insurer that there is no coverage for claim or loss. In these cases, the only way the policyholder can obtain coverage or compensation for losses is by vigorous litigation.

Generally speaking, insurance contracts are interpreted like any other contract, but there are various rules of legal interpretation which assist the policyholder in disputes with an insurer. For example, any ambiguity in the contract is interpreted against the drafter of the contract, which is generally the case with insurers.

Often, only through aggressive litigation and focused discovery can sufficient evidence be uncovered that will force the insurer to provide coverage and compensation.

When you have reliably paid your monthly insurance premiums, you rightfully expect that the insurance company will honor its obligations in the case of a disaster, accident, health crisis or death. Policyholders may feel victimized a second time if the insurer denies the claim, substitutes a lower benefit or takes an unreasonable amount of time to pay.

Trying to get the benefits that should have been paid to you without dispute can be daunting and frustrating during an already stressful time in your life. If you are getting the runaround or if your claim has been denied, our attorneys can intervene with the insurance company to negotiate forcefully and effectively on your behalf. We are not afraid to take on the largest insurers, and we have a good track record of results in a wide range of insurance coverage disputes.

Contact our firm for a free initial consultation with Jim Gigax