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Can Denied Insurance Claims Be Challenged and Overturned?

The shock of receiving a denied insurance claim can be overwhelming, particularly when those benefits are crucial for covering medical treatments or other necessary expenses. You may feel like all hope is lost, but there is potential for relief. Filing an appeal for a denied insurance claim can be difficult, but it’s possible alongside an experienced attorney. At the Law Office of Scott Righthand, P.C., we help our catastrophically injured clients take action and seek their entitled benefits. 

Understanding the Challenge Process

Navigating the complexities of insurance denials involves understanding the specific reasons for the denial and the appropriate steps to counter it. Insurance claims can be denied for various reasons. In some cases, the denial may be considered to have been made in “bad faith,” opening a window for the insured to challenge the denial. Bad faith refers to an insurer’s intentional refusal to fulfill its contractual obligations to a policyholder. This can manifest in several ways: unnecessary delays, inadequate investigation of claims, unwarranted denial of benefits or excessive requests for documentation.

When an insurer acts in bad faith, it breaches the duty of good faith and fair dealing that is inherent in every insurance policy. For policyholders, this breach can lead to undue stress and financial hardship, especially when they are already dealing with the aftermath of a personal injury or property damage.

Identifying Bad Faith Practices

Recognizing the signs of bad faith is crucial for policyholders seeking compensation. Common indicators include:

  1. Delayed Responses: If an insurer fails to acknowledge or respond to a claim within the legally mandated timeframe, it might be a sign of bad faith.
  2. Unexplained Denials: A legitimate insurer should provide a clear and detailed explanation for denying a claim. Ambiguous or vague reasoning may signal a bad faith practice.
  3. Excessive Documentation Requests: While some documentation is necessary, an insurer requesting irrelevant or redundant information may be attempting to frustrate the claimant into abandoning their pursuit.
  4. Inadequate Investigation: Insurers are obligated to thoroughly investigate claims. Rushed or superficial investigations that ignore key evidence can be a significant red flag.
  5. Policy Cancellation Under Dubious Circumstances: Canceling a policy to avoid paying a claim may constitute bad faith, especially if done without a valid reason.

Challenging a Denied Claim

If you suspect that your insurance claim was denied in bad faith, it is imperative to take swift action. Document all interactions with your insurer meticulously, including emails, phone calls and correspondence. This record will be invaluable when challenging a denial.

Consulting with an experienced attorney is the next vital step. At the Law Office of Scott Righthand, P.C., our team of skilled attorneys is well-versed in California insurance laws and adept at identifying and proving bad faith actions. We work tirelessly to help our clients seek the benefits they are entitled to, employing a comprehensive approach that includes reviewing policy language, examining insurer practices and negotiating settlements.

Review Your Options With Our Personal Injury Attorneys

Challenging a denied insurance claim can be a daunting but wise decision, particularly when equipped with the support of a knowledgeable attorney. The Law Office of Scott Righthand, P.C. is committed to helping clients navigate this process. If you’re facing a denied insurance claim, contact us for a free, no-obligation case evaluation. Let us help you fight for the benefits you deserve.

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Date Of Posting

29 October,2024

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