What Happens If Your Insurance Claim Is Denied?

April 17, 2023

When you regularly make your insurance payments and then face the unpleasant surprise of your insurer denying a claim, you may wonder, what next? What happens if your insurance claim is denied?

We bank on insurance policies to save us from financial ruin when things go wrong. In other words, we count on insurance companies to do the right thing when bad times come. However, too often insurance companies refuse to honor your valid claim. This unreasonable denial or failure to meet obligations under your insurance policy is considered “bad faith,” and to get you the benefits you deserve, you may need the help of a lawyer experienced in Oklahoma insurance law.

Your insurance company must be fair, investigate your claim promptly, communicate with you, and inform you why your claim has been denied. When insurance companies violate their duty and are found to be acting in bad faith, your attorney can seek compensation for the full insurance payment you are owed on your claim and your costs and fees (Oklahoma Statutes Title 23. Damages §23-103). You may also be able to go beyond policy limits and seek both “compensatory” and “punitive” damages.

If your case is successful, the damages you may receive can include compensatory damages for:

• Your financial losses, including your initial losses under the policy — the costs of the original accident, damages, and injuries up to insurance policy limits
• Additional financial losses such as lost wages, or lost revenue through business interruption
• Embarrassment and loss of reputation, such as financial problems caused by delayed or denied insurance payments
• Emotional distress resulting from the insurer’s improper conduct.

Punitive damages may also be awarded in rare cases to punish the insurance carrier and to serve as an example so that other insurers are less likely to engage in similar conduct.

Oklahoma’s laws are intended to discourage unlawful and unethical behavior in the insurance industry, but they are also complicated. Insurance companies have high-powered lawyers on their side, but an attorney experienced with Oklahoma insurance law knows how to fight for the benefits you deserve.

In order to win your bad faith insurance case and hold your insurer, the defendant in the case, liable, your bad faith insurance lawyer must be able to show the following elements:

• Your insurance policy required the insurance company to pay the claim.
• The insurance company unreasonably refused to pay the claim.
• The insurance company did not deal fairly and in good faith.
• The bad faith actions caused you injuries or damage.

To show the existence of these elements, your attorney would carefully investigate your claim, and look for actions by the insurance company that demonstrate bad faith. This involves examining your policy and its wording for errors, investigating the reasons for your claim, and gathering evidence to support it. Evidence could include photos and videos, witness testimony, police and medical reports, and repair costs and documents. If necessary, your lawyer may also hire expert witnesses to testify on your behalf.

With supporting evidence in hand, your attorney will negotiate with the insurance company for a fair settlement and be prepared to take your case to court if necessary.

Three Types of Insurance And What to Do If Claims Are Denied

When an insurance claim is denied, you can either accept it or fight it. When you consult with a bad faith insurance attorney, your attorney will evaluate your situation and determine what you should do and if you should take legal action to get the payment you’re entitled to.

One individual will hold many different policies throughout their life. For example, you probably have health, auto, and even home insurance. Let’s break down the three most common insurance policies to be more specific about what happens when an insurance claim is denied.

• Auto Insurance
• Homeowner’s Insurance
• Health Insurance

What to Do When An Auto Insurance Claim Is Denied

You have legal options if your car insurance company denies your claim. A bad-faith attorney can explain those options and the next best steps.

Auto insurance policies come in many different forms. You can pay an insurer to cover costs of all types, but most include basic liability insurance coverage. This protects you in case you cause someone else damage in a crash. But you can also get coverage that covers some of your expenses if you’re involved in a crash with an uninsured or underinsured motorist.

Auto insurance denials can be based on several claims by an insurance company. The company might claim that the crash was avoidable or that you were at fault. They might say that they shouldn’t cover medical expenses because you had a pre-existing condition or that medical records show you weren’t injured in the crash.

These denials are far too common, but there are steps a policyholder can take to get the payment they’ve been promised. You’re going to notice a theme on this page: your first step should be to contact a bad-faith insurance attorney. An attorney can walk you through every step of the process. They know how insurance companies work and won’t be intimidated by whatever the insurer throws at them.

What to Do When Your Home Insurance Claim Is Denied

Home insurance helps insulate you from many things that can go wrong as a homeowner. Home insurance can protect you financially from things such as floods, lightning, and fire. If an insurer doesn’t pay a claim when they should, consulting with Oklahoma home insurance claim denial lawyers can be a crucial step in determining if you have a legal case. Insurance companies often deny claims on the grounds that the damage to your home stemmed from your neglect of the property. They might claim that you misrepresented the damage to your home.

Your first step should be to contact an attorney specializing in home insurance denial cases. They can review your claim, prepare documents and pictures that build your case, and write a letter to the insurance company appealing the decision. By handling these details, an attorney will free you of worry and maximize your chances of getting your owed payments.

What to Do When A Claim Is Denied by A Health Insurer

Denied health insurance claims can make an already bad situation much worse. When you should be focusing on getting well, you don’t need to worry about fighting an insurance company. If your health insurance claim was denied, consulting with Oklahoma City health insurance claim lawyers can be a crucial step . Each situation is unique, so you’ll need to talk to an attorney about the details of your claim.

Some health insurance policies offer very little coverage, while others cover virtually any medical-related issues one might face. Insurance companies can deny a claim by asserting that the treatment or test received required pre-authorization. They might allege that you missed a filing deadline, even if you know you did not.

When your health insurance claim is denied, you can appeal the insurance company’s decision. Much like you would for other types of claims, you will review your policy, gather evidence to support your claim, write a letter and appeal the decision. Again, having an attorney to handle your health insurance claim denial will make your life easier and better position you for a favorable outcome.

Attorney Doug Terry has a strong winning record, with $200 million and $25 million verdicts won for clients in cases in which an insurer denied a health insurance claim.

Help! My Insurance Claim Has Been Denied

Call Our Bad Faith Insurance Attorney for Help

As you can see, the most effective first step after your insurance claim is denied is to contact an experienced bad-faith insurance attorney. There’s no substitute for having a legal representative who knows the process of an appeal. Your attorney will deal firmly with insurance companies and help you avoid any mistakes that could prevent you from getting the money you rightfully deserve.

Doug Terry has a reputation for being a tough opponent for insurance companies. Insurance companies and their legal teams know Doug, and they know that when he is representing a client, they’ll be dealing with someone who won’t settle for anything less than his client deserves.

Insurance companies should do right by their policyholders. Unfortunately, they often deny claims in bad faith. This is unacceptable, and you should know that you have options to get your payments. Doug Terry is here to help.

Contact us about your claim denial. If we take your case, you pay nothing unless we win.

If your insurance claim has been denied, don’t hesitate to contact the Oklahoma City bad faith insurance lawyer Doug Terry today. We offer free consultations to help you better understand your legal options. Let us hear more about your story so that we can provide you with a free initial assessment of your claim.

When you regularly make your insurance payments and then face the unpleasant surprise of your insurer denying a claim, you may wonder, what next? What happens if your insurance claim is denied?

We can help. Contact Doug Terry today by calling 405-463-6362.