What to Do if your Insurance Claim is Rejected

Entrepreneurs usually acquire a small business insurance policy to be prepared for the inevitable. But what will you do if your insurance claim is rejected when you need it the most? In this article, let’s talk about the possible reasons your claim is rejected and what you can do to do contest the rejection.

Why Do Insurers Reject Your Claim?

Now, there are times when there is a legit reason as to why your insurance claim gets rejected. So, before you dispute the denial of your claim, check first if it was because of the following reasons:

• Possible fraud on your company’s end

• Policy does not cover the claim

• Claim payout is larger than your policy’s limit

• The business didn’t pay the premium regularly

• Lacking details or non-specific details given

• Late filing of claim

• The policy has expired

If ever your claim doesn’t fall into any of these reasons, then you may file for a dispute. Follow these steps to make a dispute.

How Can You Dispute the Rejected Insurance Claim?

The first thing you do is find out why the claim was rejected in the first place. If you think the reason is legit, then stop. If you disagree, then write a formal letter to your insurance company stating the claim and the reason why they are in the wrong. Included in the letter are the documents that back up your dispute claim.

Most likely, they won’t reply to your claim, so you may try to follow up 1 or 2 times. If no action has been done, then you can go straight to the complaints manager of the insurance company and seek to file an internal dispute.

If you still feel like the internal dispute results were unfair, then you may contact the insurance regulatory board of your area or the Financial Ombudsman Services. They will help reconcile the case and give a proper resolution.

If required, you can also proceed with the litigation process. If your insurance provider refuses to pay a valid claim, they can be sued in civil court. Insurance is a type of contract, and failing to perform the agreed terms is tantamount to a contract breach. In some cases, the issue can even escalate to a tort claim.

Why is an Insurance Lawyer Necessary?

Whenever you face this kind of challenge, you’ll be brought into a maze of processes that may confuse you and make you even more frustrated. To avoid all that red tape, enlist the help of an attorney who specializes in insurance law. The lawyer will be working on behalf of your business communicating with your business’ insurance company and the insurance regulatory boards and other third-party resolution bodies.

They will also ensure that the process is fair and just so that your business won’t suffer.

Conclusion

There are times wherein you won’t be able to prevent your insurer from rejecting your claim. Sometimes, it may be your fault and sometimes it may be your insurer’s fault. If you believe your insurer is at fault, then you should take action immediately. Follow these tips to go through the right process.