Reasons Your Insurance Claim May Be Denied and How an Attorney Can Help

Every year, people in Florida are denied legitimate insurance claims for a variety of reasons. Whether it’s a health insurance claim or a claim for property damage, insurance companies have become increasingly aggressive when denying or devaluing claims.

If your insurance claim has been denied, you may feel frustrated and helpless, especially if your claim has been denied without a valid explanation. Fortunately, a qualified and experienced Florida insurance attorney can help you appeal your denied claim and understand the process of recovering wrongful denied or undervalued claims to ensure you are fairly compensated.

Below, the experienced Florida insurance attorneys at Fosky Law will explain 3 common reasons why your insurance claim may be denied and how an attorney can help.

1. Your Claim Doesn’t Match What You Originally Agreed to in Your Insurance Contract

One of the most common reasons why a legitimate insurance claim can be denied is because the claim doesn’t perfectly match the coverage you have agreed to in your insurance contract.

Insurance companies will often look for discrepancies between what was said or agreed to in your insurance contract and the actual insurance claim. This could involve whether the property loss or medical treatment was completely accurately described or how the property damage or medical treatment was reported to the insurance company.

If there is a discrepancy between your insurance claim and the actual insurance coverage you originally agreed to, even if the discrepancy is minor, the insurance company can utilize that discrepancy to claim that your claim was fraudulent or that your coverage doesn’t comply with the language in the insurance contract.

In addition, many insurance companies will use language in the insurance contract that is not completely accurate in order to limit their insurance coverage and use that language to deny insurance claims. A skilled and experienced Florida insurance attorney can help you identify these issues in your insurance contract and can work to ensure that all discrepancies between your claim and your insurance contract are appropriately addressed to maximize your chances of recovering the full compensation you need and deserve.

2. Your Claim Was Denied for Pre-Existing Conditions

Another common reason why an insurance claim can be denied is because the injury or damage is considered to be a pre-existing condition. In most cases, pre-existing conditions refer to an injury or condition that you had prior to taking out the insurance plan.

If you experienced a pre-existing condition before applying for your insurance plan, the insurance company may not cover any treatment or damage caused by it. This means that if you ever have an insurance claim related to a pre-existing condition, the insurance company may deny it.

Fortunately, a skilled Florida insurance attorney can help you navigate the complicated process of recovering a denied pre-existing condition claim and can ensure that you are properly represented in your appeal.

3. Your Claim May Have Been Williamson Act

Finally, your insurance claim may have been denied because you failed to meet the terms or conditions of the Williamson Act. Named after President William Taft, the Williamson Act states that a person must provide timely notice of an insurance claim to their insurance carrier. For example, if you are filing a property damage insurance claim, you must do it as soon as reasonably possible after the damage occurs.

On the other hand, if you failed to provide the notice to your insurance carrier in a timely manner, your claim may be denied. Additionally, your claim may also be denied if the notice you provide to your insurance carrier is inadequate or incomplete.

The skilled Florida insurance attorneys at Fosky Law understand the complexities of insurance law and can help you appeal a denied claim for failing to meet the conditions or terms of the Williamson Act.

Conclusion

Insurance companies often deny legitimate insurance claims in order to limit their financial burden, which can leave innocent policyholders struggling to get the compensation they deserve and need. Fortunately, there are experienced and skilled Florida insurance attorneys who can help you appeal your insurance claim if it is wrongfully denied or undervalued.

If you or a loved one have experienced a denied insurance claim, the experienced Florida insurance attorneys at Fosky Law can help you get the compensation you need and deserve. For more information or to schedule an initial consultation, contact the Fosky Law offices today.