Posted in Uncategorized
When an insurance company denies a claim, it can be frustrating and financially stressful. We pay premiums expecting protection when things go wrong, so getting a denial letter feels like a setback. If you’re dealing with this situation, there are clear and practical steps you can take to challenge the decision and push for a fair outcome. Call our San Francisco, CA insurance dispute lawyer today who brings decades of legal experience!
Review The Denial Letter Carefully
Your first step is to read the denial letter carefully, and you may want to hand it off to our legal team. Insurance companies are required to explain why they denied a claim. They usually point to specific policy provisions or claim that certain conditions weren’t met. Pay close attention to any timelines mentioned for appeals or additional documentation. Understanding the reason for denial gives us a solid starting point for our response.
Check Your Policy Terms
Next, we should review the policy itself. It’s important to compare the denial reason to the actual language in your policy. Sometimes, insurers deny claims based on vague or overly broad interpretations. If the denial doesn’t clearly align with the policy terms, that’s something we can challenge.
Gather Supporting Documentation
We need to collect all documents that support your side of the claim. This can include photos, reports, receipts, medical records, witness statements, and correspondence with the insurance company. The more detailed and organized your file, the stronger your appeal will be. Gathering evidence can help prove fault in personal injury cases.
Submit A Formal Appeal
If the policy allows for internal appeals, we’ll need to follow that process before considering legal action. This usually involves writing a detailed letter explaining why the claim should be approved, supported by your documentation. Be clear, factual, and direct. Stick to the facts and avoid emotional language. Remember, the appeal is our opportunity to challenge the decision using their own rules and standards.
Keep Track Of All Communication
Throughout this process, it’s important to keep copies of everything we send and receive. Note the dates and names of anyone we speak with at the insurance company. These records may become useful if the dispute continues or if we need to escalate the matter legally.
Consider Legal Help When Needed
If your appeal is denied or you believe the insurance company acted unfairly, you may have grounds to take further action. California law requires insurers to handle claims in good faith. When they don’t, legal remedies may be available. Our team can provide you with the help you need, including helping you explore disability benefits during employment. Our attorneys can help identify whether the denial violated state law or breached the policy terms.
At The Law Office of Bennett M. Cohen, we understand how stressful and confusing an insurance claim denial can be. If you’re feeling stuck or unsure of your next steps, we’re here to talk. Our attorney, Bennett M. Cohen, has handled various cases, including representing clients against massive companies like the Shell Oil Company. Contact us today to schedule a consultation and find out how we can help you move forward!
