John J. Wright

Information Technology Resources

How to Avoid an Insurance Claim Denial

Posted by on Oct 14, 2013

Insurance companies have a formula for handling claims: delay, deny, and defend. Insurers have a whole set of strategies that will prolong the date of payout as long as possible. This is because every day that a payout is delayed means money in their pocket in terms of interest and the like. According to the website of law firm of the insurance lawyers of Smith Kendall, PLLC, delays in a payout can have serious consequences for the insured if time is of the essence.

If it is at all possible, the company will issue an insurance claim denial on the flimsiest of pretexts such as an improperly filled out claim form, errors in the insurance form, and so on. A claimant can always dispute the denial, of course, but that also means more delay.

Typically, the insurer also has the upper hand when it comes to defending a payout or denial because they have the advantage of knowing exactly what a policy says and means. All this means a lot of frustration and loss for the insured, which should be avoided.

The best way to avoid an insurance claim denial is to know exactly what the coverage of the insurance policy is. If there are certain terms and conditions in the contact that are not clear, have the company explain it in detail.

It is also a good policy to always be prompt in paying premiums. Insurance companies are quick to pounce on any chink in the a claimant’s armor that could be used to justify a delay in paying a claim, a reduced payout, or an outright denial of coverage.

Consult with an insurance lawyer as soon as it becomes apparent that the insurance company is going to be difficult to deal with regarding a claim. It not only sends a message to the insurer that the claimant is no pushover; it also brings up the specter of an expensive lawsuit if the claim is valid.

Read More