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Insurance Bad Faith FAQ

Answers To The Most Frequently Asked Questions In Bad Faith Insurance Cases

1. Is it important to read my insurance policy before filing a claim?

Yes! No matter what kind of policy you have, it is of the utmost importance that you have copy of your policy and are familiar with as many of its terms as possible. The best protection against being denied the coverage you are owed is to know what you are entitled to by way of benefits, and know what benefits the insurance company owes you. Additionally, if you are not familiar with the contents of your insurance policies it is possible you do not actually have the coverage you think you have. Reviewing your policy will give you the chance to remedy that before disaster strikes.

2. I want to make a claim for benefits under my insurance policy. My insurance company sent me a claim form. How do I fill this out?

First and foremost, you must be completely honest with the insurance carrier. Any lies or omissions contained within the claim form gives the insurer grounds to deny coverage. Secondly, document your loss with as much detail as possible. If you have photographs of the lost or damaged property you seek benefits for, include those; if no photographs are possible, describe the lost or damaged property with as much particularity as you can. Include any receipts you might have.

3. What should I do before filing for disability benefits?

Before you even apply for benefits, the first thing you need to do is read through your policy very carefully to make sure your condition qualifies you for benefits. Before filing, you must also review your initial application for disability insurance and make sure everything you disclosed on the application was truthful. Once you make a claim for disability benefits, you must assume the insurance company will obtain all of your medical records. If you were untruthful in your application, or something in your application is no longer true, you must contact the insurance company and supplement your application before filing for benefits. Failure to disclose information in your application can be valid grounds for denial of benefits and termination of coverage.

4. What happens after I submit my claim for disability benefits?

Typically, the insurance company will begin to pay you after a short grace period. This is generally done under what is called a “reservation of rights” while investigating your claim. This means the company is paying you benefits but not admitting that it actually owes you anything. During this time, the insurance company will probably seek out your medical records and possibly your tax returns for the past few years. The company is entitled to a certain amount of background information on you, but is not permitted to seek excessive or irrelevant information.

5. If I’m disabled from my current occupation but am able to do a different kind of work can I still collect disability benefits?

This depends entirely on the language of your insurance policy. Most disability policies protect you only if you are disabled from any line of work for which you are trained or qualified. Some, however, will entitle you to benefits if you are disabled from the specific occupation you held when you obtained the insurance. Read your policy carefully to determine which kind of policy you have.

6. What can I do to protect myself during the claim investigation process?

Document every conversation you have with a claims representative, including the name of the person you spoke with, the length of the conversation, and the date. Retain all correspondence. Should your claim later be denied in bad faith those conversations and that correspondence may be important evidence. In the case of disability and health insurance claims, be aware that the insurance company may be videotaping you secretly, looking for behavior that may contradict the claims you are making. Therefore, be careful when in public places not to engage in activities that would give them reason to deny you or terminate your benefits.

7. My insurance provider has terminated my disability benefits. What should I do?

First of all, do NOT stop paying your premiums, because this will give them grounds to terminate your coverage in addition to discontinuing your benefits. Make doubly certain that your policy does in fact cover your particular injury/disability. If you feel it does, you should then obtain medical documentation supporting your disability and send it to your provider. If after submitting this information the insurance company continues to deny your claim, it might be time to seek legal representation.

8. I feel that the estimate my insurance carrier made for my damaged property is much lower than it should be. What should I do?

Some insurance companies try to cheat their insureds when giving estimates by quoting settlement amounts that are far below what they should be. When filing a claim for lost or damaged property it is smart to obtain an independent professional’s estimate of what the value is. This can give you leverage against your insurance company and will probably help you or your attorneys negotiate a higher settlement.

9. What will happen if I involve an attorney in my bad faith insurance dispute?

No matter what type of insurance policy you have, frequently all that is necessary for an insurance company to pay your owed benefits is for an attorney well versed in bad faith insurance law to notify the insurance company that she or he is involved in the case. If your benefits are not reinstated at that point, however, you may file a lawsuit against the company for a bad faith denial or termination of your claim. The amount of money you might receive from any bad faith lawsuit, however, depends a great deal on whether you obtained your insurance policy as a benefit from your place of employment (which could limit your recovery) or whether you purchased it on your own.

Most legal questions require complex answers. The answers provided here may not be complete or fully accurate but attempt to provide consumers with abbreviated answers. For more detailed answers to these questions, a consumer should check out other articles in this section of this website, research other legal articles and texts on the subject matter or consult with an attorney.

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