Know Your Policy: Some Conditions May Lead to Denial of Your Claim


As the holidays come and go, most of us have been busy saving up for a variety of purchases—and then recovering from not only multiple food comas, but also financial hangovers! Along with that comes all the usual expenses, including insurance—one of those bills that tends to remain front and center in our lives. While it is not always required, a variety of different policies are recommended, from auto to life to commercial, and more. And not only is insurance a monthly to quarterly to annually bill, it is often a lifelong bill. That means thousands of dollars paid to an insurer, so make sure it is going to a worth cause in the end, if needed, and that would be you!

You may be paying for one or more insurance policies, but do you really know the details? Insurance can be tricky, from choosing the best insurance agent to understanding a variety of different policyholder issues. Most important though is understanding what you are covered for, and whether you are lacking in protection; after all, a catastrophic loss could affect your finances enormously if you do not have enough insurance. The hope is that you will never need to file a claim, but if you do, it is vital to know what financial resources will be available to you through your insurance policy.

The auto policy is always a good example, as most of us own one but still may not quite understand it fully, along with what could cause the insurer to deny your claim—and solidly so. California requires you to carry liability insurance only, but many other options are available such as comprehensive and collision, which may also be required before you can drive a new or used car off the dealer lot. You should understand what you are or what you want to be covered for in terms of medical payments, personal injury protection, uninsured motorists, and more.

More importantly though—and this goes for all your insurance—understand what you can do to make sure you don’t make it easier for the insurer to deny or delay your claim. Again, using car insurance as an example, understand what your policy covers and might be denied due to your actions or negligence—or simple lack of payment and cancellation of policy that could have already occurred.

If you have been injured, get medical treatment immediately. Any delays in going to the hospital or doctor’s office may raise serious questions. Make sure all your concerns are documented, and keep in mind that your medical records may be requested. Be aware that if the accident was your fault due to an issue such as reckless driving or driving under the influence, the claim could be denied. Distracted driving is also one of the top reasons for traffic fatalities and injuries, and it is proved that you were not paying attention to driving but fiddling with an electronic device instead, again there is the possibility for denial.

For other insurance policies, know what is expected of you when there is damage or other reason for a claim. If the insurer is not responding, know the signs of impending bad faith practices such as lack of investigation, unreasonable delays, low-ball offers, or a denial that seems unreasonable.

Are you concerned about a recent claim, or are you trying to understand your insurance policy? If a dispute over a claim cannot be easily resolved through a call or written communication, the Bolender Law Firm will advocate on behalf of policyholders through litigation, arbitration, or non-binding mediation. Our attorneys are experienced in representing clients in state and federal courts, at both the trial and appellate level. Call us at 310-320-0725 now or submit an easy consultation request online. We are here to help!


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