People pay for insurance to protect their financial well-being when unfortunate events, illnesses, or injuries strain their resources. Regrettably, insurance companies do not always work with their policyholders and use fine print, loopholes, or even dishonesty to avoid paying claims.
If your insurance company is delaying or refusing to honor your claim and policy, you are not without recourse. An Augusta insurance claims lawyer from John Foy & Associates will take up this fight for you and hold the insurance company in question responsible for what they owe you.
Contact our Augusta personal injury lawyer today to discuss the details of your case.
Why Insurance Companies Deny Claims
The bottom line for most businesses, including insurance companies, is profit. Though the apparent purpose of insurance companies is to protect policyholders, the primary goal is to make money.
Insurance companies enjoy greater profit when policyholders do not file claims or do not collect on claims they submit through their policies. Companies may also undervalue claims, protecting their bottom line while giving policyholders paltry coverage. Sometimes, companies deny claim after claim, even those that are legitimate, investigating only if the policyholder forces their hand through legal action.
Do not back away from a battle with an insurance company. John Foy & Associates, the Strong Arm, will provide you with the legal power you need to demand action and fair coverage.
How Insurance Companies Deny Claims
Insurance companies use a variety of tactics to deny claims. For example, they may:
- Interpret or manipulate the language of a policy to minimize or dismiss legitimate claims
- Accuse the insured of “material misrepresentation”
- Allege the policyholder did not pay premiums on time, resulting in a lapse in coverage
- Claim the injury or property damage, etc. falls outside the range of coverage
What Is “Material Misrepresentation?”
A material misrepresentation is a statement made with the intent to deceive or mislead the other party using information that is material–that is important–to the situation at hand. In some cases, material misrepresentation is criminal, an act of insurance fraud.
For example, if an employer misrepresents the number of workers they employ to avoid paying higher workers’ compensation premiums, this is a material misrepresentation. If a driver claims they were hit by another vehicle that left the scene when they actually ran their car into a tree, this is a material misrepresentation.
Sometimes, however, insurance companies will make claims of material misrepresentation that are unwarranted or hardly related to the event requiring coverage. They may mine for small or unintentional errors in your application and seek to deny your claim on unfair grounds. To protect yourself and the compensation you deserve, trust an insurance claims lawyer in Augusta to handle these accusations.
Protection for Insurance Policyholders in Augusta
It is important to remember that Georgia has laws in place to protect insurance policyholders. Too often, policyholders do not know this and are intimidated by insurance companies into believing a denial is final, a low settlement is all they can get, or that the insurance company’s delay in payment is just the way the system works.
Georgia, along with most other states, has adopted the Unfair Claim Settlement Practices Act to protect the rights of Georgia’s insurance policyholders. Companies can be held liable for unfair claims handling when they avoid paying legitimate claims or reduce the payments they owe policyholders. They may carry out these unfair acts through fraud, by misleading or outrightly deceiving policyholders, refusing to fulfill their contractual obligation, or committing some other conscious wrongdoing.
Do not accept denials or low settlements–or any settlement–without first partnering with an insurance claims attorney in Augusta. If your insurance company is treating you unfairly, you may have a bad faith claim. Or, you may have a case for breach of contract or an unfair claim denial. Your attorney will know how to pursue justice.
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Secure Legal Representation as Soon as Possible
The best course of action is to work with a lawyer even upon filing your claim. When your insurance company sees you have someone who fully understands the laws that protect you and has read all the often misleading fine print, adjusters will be less likely to employ unfair strategies. However, most policyholders start off trusting their insurance companies and need this initial legal power in place.
Though the statute of limitations for filing a bad faith or breach of contract claim against your insurance is six years, according to Georgia law, some policies include language that significantly limits those terms. Therefore, the sooner you secure legal help from an Augusta insurance claims lawyer, the better.
How Your Augusta Insurance Claims Attorney Will Help
Your lawyer will work diligently to gather information about your case and collect evidence to support your claim.
Understanding the Denial
Your attorney will review your insurance policy and relevant reports, police, fire, or accident, for example, as well as any other communication you received from the insurance company. Of course, this documentation includes the denial letter. Georgia requires insurance companies to give policyholders a basic explanation for the claim denial.
Once your attorney understands the reason for the denial, they can work on building a legal argument against it. Insurance policy and legal language are often difficult for those without insurance or legal backgrounds to navigate. An Augusta insurance claims attorney has the skills and background necessary for interpreting that language and protecting you from manipulation.
Collecting Evidence
Your attorney will gather evidence to prove the insurance company’s denial, or low settlement offer, is an example of bad faith or breach of contract. Evidence will likely include reports on the value of the damages you have suffered.
Providing Representation
Your attorney will handle all negotiations with your insurance company and hopefully reach an agreement out of court. This is not always the outcome, though. You may need to take your insurance company to court, in which case, your attorney will provide you with the highest-quality representation at all proceedings.
Do Not Take “No” for an Answer
When you have suffered an injury, illness, or property damage, the last thing you need to deal with is an unfair, uncaring, and uncooperative insurance company that refuses to honor your policy. Fortunately, you do not have to. Instead, contact John Foy & Associates to partner with an Augusta insurance claims attorney.
Your attorney will not allow an insurance company’s unfair “no” to be the final answer, and will work to get you the settlement you need and deserve.
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