When insurance companies are refusing to pay claims, you have the right to take legal action. This is especially true if the insurance company is acting in bad faith. If your insurance claim has been denied by your insurance provider in South Dakota, don’t waste any time following up on it. This article walks you through which steps to take when your insurance company has denied your claim and how to know if your provider is acting in bad faith.
Know the Reason the Insurance Company Denied Your Claim: Could it be bad faith insurance?
There are a few reasons the insurance company could have denied your claim. It’s always important to know which reason your denial falls under. Some of the most common reasons claims are denied are:
- The claim was filed with mistakes – Make sure all of your bases are covered when submitting your claim. If a claim contains incorrect information and/or is not compliant with all requirements needed for submission, the provider might deny your insurance claim. In many cases, you should try to work out any administrative error with your insurance company as a first step. Make sure you contact the provider as soon as possible.
- The claim contained fraudulent information – It’s important for policyholders to never falsify or exaggerate claims, as this could result in criminal or civil charges.
- There is a lack of coverage – Many times people think they have coverage that they may not actually have. They find out later that the fine print excluded the specific type of accident or procedure reported in their claim.
- The coverage has expired or lapsed – With automatic renewals comes details that you may accidentally neglect. Some coverage will automatically renew, and some will need action on your part before renewal. Don’t assume – be sure to understand which coverage you may need to manually renew.
- You neglected to seek treatment in a timely manner – It is important to seek immediate medical attention. If there is a delay, the insurance company may deny your claim, citing that because you did not seek immediate medical treatment, you were not hurt. Furthermore, after an accident, it’s wise to get checked out for your safety and health.
- There was a failure to notify the insurance company – You should notify your insurance company instantly. If you wait a week or longer, the insurance company could deny your claim, citing the inability to investigate the claim.
- A bad faith insurance denial – Bad faith insurance refers to an insurer’s attempt to retract on its obligations to the insured, either by withholding payout on a policyholder’s legitimate claim or by not investigating and processing a claim within a reasonable period of time. If you believe your insurance claim has been denied in bad faith, you should contact a South Dakota bad faith insurance attorney immediately.
Appeal Your Insurance Denial
Ensure that you carefully review the denial letter to understand for which of the above reasons the insurance company has denied your claim. Once you know the cited reason, your attorney can help you appeal the denial of your insurance claim. The first step to appealing your insurance denial is gathering the evidence. A South Dakota bad faith lawyer can help you gather any documentation you need to pursue your appeal; this documentation could include any of the following items:
- Medical records
- Police reports
- Photos of the car accident
- Statements from the witnesses of the car accident
- Statements from family and/or friends about how the accident may have impacted your life
- Referrals from your doctor for treatment
- Prescriptions
Once the evidence has been gathered, it’s time to fill out the insurance claim denial appeal paperwork that the insurance company will provide. The insurance claim appeal process information can usually be found on the insurance provider’s website. If you do not find the appeal paperwork on the insurance company’s website, call them to find out what is needed to submit your insurance denial appeal. Using the provider’s appeal forms typically provides a more prompt response than writing your own letter of appeal.
Once you have double-checked all of the fields and documentation, be sure to keep all files and evidence in an organized place to ensure that you can find everything you need should you need to come back to it at any point in this process. This includes all reference numbers and any emails you receive from the company, as well as any representatives’ names to whom you have spoken.
The process could take a frustratingly long time, so be sure to follow up. Insurance companies make a lot of money on people who drop their appeals because of the length and tedium of the process. These delays are a sign your insurance company may be committing bad faith.
My Appeal Was Denied. Can I Take Legal Action?
Yes, you can take legal action if the insurance company is refusing to pay claims, especially if that company has acted in bad faith. The law requires insurance companies to act in good faith and abide by the terms of your insurance policy, meeting all obligations. If they have not fulfilled this, they have participated in unfair trade practices and can be held legally liable. If you believe you have a bad faith insurance case, contact Turbak Law Office, P.C. today. Some signs you may have a bad faith insurance case are:
- An insufficient and delayed investigation into your claim – If your insurance company keeps coming up with reasons not to pay you your compensation, it is time to contact a South Dakota bad faith insurance attorney
- Low compensation offers – Don’t settle for less than you deserve. Some insurance companies delay for extensive periods of time, hoping that when they finally offer you payment, you’ll accept less than you deserve. An insurance lawyer will help you get paid fair compensation.
- Denial of your claim – If your claim is correct and legitimate, the insurance company should pay it in accordance with your insurance policy
- Failure to approve or deny your claim in a reasonable amount of time – Any unreasonable delays could be a sign of bad faith
If your insurance company is showing any of the above signs of bad faith insurance in South Dakota, it’s time for you to take action.
Don’t Go Up Against the Insurance Company Alone
Having a bad faith insurance attorney on your side through this process is highly recommended. While you can go through the insurance claim appeal process alone, it is a good strategy to consult an insurance attorney to guide you through the process. In fact, if there is a lot at stake within your claim, it is highly recommended that you contact an attorney as soon as possible. If your claim is expensive, complex, or it’s difficult to establish where the fault lies, you should contact an attorney at the very beginning of the process when you are initially filing your claim. At the end of the day, insurance companies make more money by finding reasons or excuses to deny your claim and avoid paying you insurance benefits. Don’t take any chances when it comes to getting your compensation.
Contact Turbak Law Office, P.C. Today
If you think an insurance company is acting in bad faith or have a complex, high-stakes claim, call Turbak Law Office, P.C. today at 605-886-8361 to understand your options. Additionally, you can submit this online form, and we will reach out to you. Turbak Law Office, P.C. is dedicated to helping you get the financial compensation you deserve.