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Duties of a Lawyer in Settling Denied and Unsettled Insurance Claims. - Kyambadde Associates & Legal Consultants

Sunday 8 September 2019

Duties of a Lawyer in Settling Denied and Unsettled Insurance Claims.

Consistent rejections of insurance claims against another driver or the citizen that incurred damage to property are severe problems when the policyholder needs to get hold of the funds immediately. The policyholder thus needs to consult a lawyer to get things in order.

Why Do Insurance Claims Get Denied?
The negligence of the administration department is often the root cause behind the denial of insurance claims, while incomplete documentation is also another major reason as to why the insurance claims are denied. The policyholder needs to go through the paperwork to see what document is missing or incomplete. Yet for administration issues, the insurance company might be having a problem with verification of documents. Other types of rejections are mainly concerned with the bad faith of the insurance carrier, even if the claim a policyholder files is 100% valid.

The Insurance Carrier’s Bad Faith! 
A lot of times the insurance carrier expresses bad faith towards its policyholders. Communication gaps and inconsistencies cause this problem. The insurance carrier may deny all your requests and may also refuse to take your phone calls. It doesn’t really matter how valid your claim is, if an insurance company is not willing to entertain your request, it certainly won’t. No matter how hard you try on your own!

How to get out of the insurance claim denial cycle?

File a demand letter: 
Filing a demand letter is the most-convenient method to seek an insurance claim settlement with a carrier. This document outlines several provisions that ease the overall process. In this document, you need to mention how legitimate your claim is and why it is important for you to settle the claim amount. If your insurance company hasn’t responded well to your previous queries, consider dropping it off a concise demand letter. This would be your first litigation step in an attempt to resolve your case.

Adjust your claim amount:
Bear in mind that the insurance adjusters would never compensate you in full. This is why you must know what rights you possess and the things you can do to receive the compensation you truly deserve.
Your insurance adjuster will try its level best to make you compromise with an unjustified insurance claim. Your medical or police record will be duly referenced by your insurance adjuster to make things complicated for you. In such a scenario, you must not respond with aggression. You must strengthen your agenda with readily available facts & figures in order to receive the compensation you truly deserve.
Patience is the key here… Make sure that you don’t fall a prey to your insurance adjuster. And during the entire negotiation process, make sure that you evaluate the offers and counter-offers wisely. Every offer proposed by the insurance company must be in line with your case.
It is, however uncertain that how long your negotiation process goes, but after a few conversations between both the parties (you and your insurance adjuster), you will get closer to a possible negotiation.

Make a court appeal: 
If you are unable to settle your unsettled insurance claims on your own, then consider appealing to the court. If the amount of the damages doesn’t surpass the limit of the state where you are living, you may file a case in a small claims court. The best part of appealing the small claims court is, you are not required to physically appear in the court or even go through legal proceedings to come up to a final conclusion.
To its contrast, if your insurance claim is higher than usual, you may have to file your case in a civil court. In a civil court, your due amount would be decided by the judge, and the insurance company will bear that particular amount. In this scenario, you would have to consult a personal injury attorney to represent the case on your behalf. The reason why you must consult a personal injury attorney for larger claims is, there’s a hefty amount under the possession of the insurance company and claiming such a big dispute requires great amount of resources.

Pressurizing through a lawyer: 
Legal consultation firms like CohenWinters start by putting pressure on the insurance company after the policyholder receives a straight refusal or a below par claim offer. Then the official communication takes place between the lawyer and the insurance company and all documents are scrutinized in order to highlight the chances of settlement or increase the already proposed claim amount. It is, however, possible that the consulted law firm takes your matter to the court if things don’t turn into your favor with soft negotiation talks. If your case is totally valid and you consult a reputed law firm like CohenWinters, the insurance company would be left with no other choice except for seeking an agreement with you.

Regardless of what type of accident you met with or what extent of damage was caused to your property, you would definitely tend to settle the issue outside of the court due to the cost it incurs to engage the court in these matters. The better alternative to this is to consult a third-party legal professional who would negotiate on your behalf to settle the case with your insurance company. Your consulted lawyer or law firm would collect necessary evidence and process the same to defend your case in order to get back to you with a positive response.

Do you really need a lawyer to settle your denied & unsettled insurance claims?
Even if your claim is genuine and justifiable, chances are you’d get denied every time you consult your insurance company. You, as a policyholder would thus need to consult a third-party law firm in order to negotiate your insurance settlement amount. Doing it on your own won’t help you much and you may end up with a compromised offer.

Qualities of an Insurance Claim Lawyer You Must Really Look Out For?
Upon consulting a lawyer for settling your denied & unsettled insurance claims, you must look forward to below qualities that an ideal lawyer possesses:

- Negotiation skills and logical-reasoning;
- Result and time-oriented;
- Works to the best of your interest regardless of how complex the situation gets;
- Prompt availability to respond to your immediate queries;
- Gap analysis to determine whether your insurance claim is sufficient or not;
- Proper gathering of evidences to make your case more apparent and winning;
- Mindful suggestions for alternate options to clients in an event of a complete denial from insurance companies;
- Past history of dealing with unsettled insurance claims.

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