Mansell, Engel & Cole

When your insurance company wears you down

You paid your premiums faithfully, even after they went up for whatever reason. While it may have been a while since you read over your policy, you are confident you know what the insurance company has agreed to cover if you should ever make a claim. When they pay the appropriate amount of a claim on time and without hassle, they have acted in "good faith." They have taken your money with every intention of keeping their end of the bargain.

However, you may be pouring over that policy right now trying to figure out why the insurance company has denied your claim. It's all right there in the thick documents - at least you think so. It may be hard to understand exactly what some of the legal terms and phrases mean. Nevertheless, you were probably depending on that money, and now you aren't sure what to do.

Good faith, bad faith

When an insurance company denies your claim, there may be a very good reason. Perhaps you missed a payment or accidentally let the policy lapse. Maybe your policy clearly states that it will not cover you under certain circumstances. The letter the insurance company sent you telling you your claim was denied should have explained the reasons for the denial.

If you feel the explanation does not ring true, it is possible that the insurance company is acting in "bad faith." They may have had no intention of fulfilling their promises after they got your money. An insurance company may be acting in bad faith if it does the following:

  • Refuses to investigate your claim
  • Unreasonably delays the investigation of your claim
  • Does not fully and fairly investigate your claim
  • Undervalues your claim
  • Denies a claim for which you believe you are fully covered

Most insurance companies in Oklahoma act in good faith. The reputation of their industry depends on it. However, if they denied your claim, you have every right to appeal. It could be a simple, clerical error or misunderstanding of the policy language that resulted in your claim denial.

Motivating insurance companies to operate honestly

An appeals process is often long and confusing. The insurance company will likely ask you for further documentation of your claim or written explanations of your interpretation of policy coverage. An unprincipled insurance company may drag out the appeal until you are too tired to fight. Another tactic may be to pay you part of what they owe you so that you will be satisfied with something instead of nothing.

If your insurance company denied your claim, you may benefit from the help of an attorney. Attorneys who deal with denied claims and bad faith insurance companies already understand how hard you work for your money and how important it is that you get what you paid for. If your insurance company has created a hardship for you by denying a legitimate claim or prolonging your appeal, you may be entitled to compensation for damages as well as the policy benefits they owe you.

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