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Can I Sue an Insurance Company for Denying My Claim?

Dealing with property damage, injuries, death of a loved one, or some other misfortune is hard enough. So, if you’re forced to battle your insurance company on top of all that, it’s easy to feel overwhelmed. Thankfully, there are many laws designed to protect consumers like you, and it’s not uncommon for a policyholder to sue his or her insurer. Read on to learn about the basics of suing your insurance company for denying your claim or other misconduct.

Reasons an Insurance Company May Deny Your Claim

An insurance company has an arsenal of reasons to give you for denying your claim, some legitimate, some not. Some of the more common reasons include:

  • Lack of coverage: They may argue that your claim isn’t covered by your insurance policy. Examine your policy’s exclusions section to better understand what’s not covered. Ambiguities in the policy are judged in favor of the policyholder, not the insurer.
  • Application errors: An insurer may claim you made certain misrepresentations on your original application that nullify the coverage of your policy.
  • Claim errors: Check your policy to see what the requirements are for notifying the insurance company of a claim. Some timelines are as short as 24 hours.
  • Insurance fraud: Submitting false or exaggerated claims can amount to insurance fraud, carrying civil and criminal consequences.
  • Bad faith denial: Of course, they won’t give you this reason, but an insurer might offer many justifications, couched in confusing policy jargon, to simply disguise the fact that they just don’t want to pay for the claim

When Can I Sue the Insurance Company for Denying My Claim?

Every insurer has many obligations to its policyholders. They must abide by the terms of the contract (the policy), act in good faith, and avoid unfair trade practices. Their precise duties vary from state to state, since the insurance industry is generally regulated at the state level. However, these obligations typically require the insurance company to refrain from the following:

  • Inadequate and delayed investigation into the claim
  • Refusing to pay a claim where liability is reasonably clear
  • Failing to approve or deny a claim within a reasonable or specified timeframe
  • Denying a claim with little or no explanation as to the reason for the denial
  • Failing to defend you in a liability lawsuit where at least one of the claims is potentially covered by your liability policy
  • Denying a claim based on an application misstatement after the period of contestability has past

If you believe your claim was improperly denied and your insurer doesn’t seem to be budging, you can look into suing your insurance company. However, you should also think about contacting an insurance attorney before your claim is denied if you think your insurance company is being unfair. Sometimes the presence of an experienced insurance professional can help persuade the company to better honor its obligations and agree to a fair settlement.

What Types of Legal Action Can I Take Against My Insurance Company?

Again, each state has its own statutes and case law regulating the insurance industry, and these include the types of lawsuits you can bring against an insurer. Every state allows for a breach of contract action, since your insurance policy is a type of contract. Many states also allow you to pursue a bad faith tort lawsuit. Additionally, you may be able to sue under your state’s unfair trade practices laws. Many states have codes or statutes which pertain directly to trade practices within the insurance industry.

An insurance attorney can explain the kinds of damages available to you, since each state has different rules about the types of damages you can pursue in a given lawsuit. However, compensatory damages, such as medical expenses and lost wages, are available in each of these kinds of lawsuits. On the other hand, punitive damages are only available in some cases and may be limited by state law or the court.

Tips for Suing the Insurance Company for a Denied Claim

Whether you’re currently considering suing your insurance company or not, it’s always best to be prepared and keep detailed records. Some ideas to keep in mind include:

  • Document any correspondence with the insurance company and its representatives. Keep copies of emails and take notes of phone conversations, including dates and the names of representatives. Stay calm and assume they’re recording your calls.
  • Maintain records of your insured property, including receipts and pictures of what’s insured. Take pictures of property, like your car or home, immediately after an accident.
  • Keep track of expenses you incur, such as medical bills, repairs, attorney’s fees, and lost wages. Be honest in your assessments and record-keeping.
  • Choose an attorney with extensive experience in insurance litigation. Insurance law can be complex, time-consuming, and expensive.

If you do decide to sue your insurer, having this sort of documentation will help your attorney present a strong case.

Don’t Go Up Against Your Insurance Company Alone

If you’re at the point where you’re thinking of suing your insurance company for denying your claim or committing other misconduct, it’s time to look for a local insurance attorney who can defend your interests. You’ve already had to deal with the events giving rise to the insurance claim in addition to the headache of an uncooperative insurer. Plus, you can bet that the insurance company will be well-equipped with their own team of experienced lawyers doing everything they can to defend their client. Level the playing field by contacting an insurance attorney today.

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