Insurance Law Blog

blog image

Common Scenarios for Denied Insurance Claims and How an Attorney Can Help

November 08, 20234 min read

7 Common Scenarios for Denied Insurance Claims and How an Attorney Can Help

Insurance can help individuals prepare for the unexpected. It can provide financial support when an individual needs it most, such as when they’ve sustained an injury, suffered a loss, or endured other hardship. Unfortunately, in some cases, insurance companies deny individuals the coverage they need. When this happens, it can leave a family struggling to cover the costs of their care and living expenses.

When insurance companies deny a claim, many individuals can benefit by working with an experienced Florida insurance attorney who knows exactly what to do. The challenge is knowing when it’s time to contact a lawyer and when to try and handle the situation on your own. In this blog post, we’ll review 7 common scenarios in which seeking legal help from an experienced attorney may be the best solution for a denied insurance claim.

1. Denial of Medical Treatment

When an insurance company denies coverage for medical care, it can leave individuals unable to pay for the care they need. If you’ve been denied medical treatment, an attorney can look into the claim and determine if your insurer legally has the right to deny your claim. Your attorney can also provide advice about your legal options and help you obtain the coverage that you are legally entitled to.

2. Denial of Disability or Long-Term Care Benefits

When insurance companies deny disability or long-term care benefits, it can be incredibly difficult to manage all of your expenses. An experienced attorney can help you determine the best way to manage all of your costs. Your attorney can also review your policy to make sure that it's in compliance with the law, and help you fight to get the coverage you deserve.

3. Denial of a Claim Because of an Outdated or Wrong Policy

Mistakes happen. It's possible that an individual may have an outdated or wrong policy for their coverage or that an insurance company didn't provide an appropriate explanation about benefits or coverage limits when issuing a policy. An attorney can determine if the insurance company met its obligations and help you understand what you may be entitled to.

4. Denial of a Claim Because of an Error on the Application

Sometimes, individuals make an innocent mistake on a policy application, but the insurance company may deny a claim because of the error. Your attorney can review the application and, if applicable, help you get the coverage you need.

5. Denial of a Claim That Should Have Been Covered

An experienced insurance attorney can go over the type of policy you have and find out if the claim should have been covered. If it should have been covered, the attorney can help you find out the best way to challenge the denial and protect your rights.

6. Denial of a Claim After an Unsatisfactory Settlement Offer

In some cases, an insurance company may offer a settlement or payout that is much smaller than an individual is entitled to. If this is the case, your attorney can help you negotiate a better settlement or review the existing offer to make sure it is fair.

7. Denial of a Claim Because the Insurance Company Intentionally Misclassified It

If an insurance company incorrectly classifies an individual’s claim, this could lead to the denial of the claim. For example, if a claim is classified as “non-covered” when in fact it should be “covered”, the insurance company may deny the claim. An experienced attorney can help you determine if the insurance company intentionally misclassified your claim and ensure you get the coverage you are entitled to.


Insurance is intended to help individuals in case of an accident or illness. Unfortunately, insurance companies deny claims all too often. If you’ve had a claim denied, it can be difficult to know what to do. Working with an experienced Florida attorney who specializes in insurance law can help you understand your rights and determine the best solution to the problem.

If you’re in the process of being denied an insurance claim, or if you feel intimidated by the process, consider seeking the help of a qualified attorney who can help you navigate the situation. At Fosky Law, our team of experienced Florida insurance attorneys can help you secure the coverage you need and get the compensation that you are rightfully entitled to. Contact us today.

Back to Blog