Explaining The Insurance Dispute Resolution Process

Insurance is purchased to help consumers in times of need. Whether it is for your car, health, home, or in the event of a disability, people buy insurance as a back-up for situations where they think they will need it. When someone has to make a claim to an insurance company, they are expecting to have the insurance cover the costs incurred. However, that is not always the case. Insurance lawyers know that companies are experts at disputing and denying claims. If you feel your insurance company has denied your claim in “bad faith” contact one of the experienced attorneys at the Coye Law Firm today.

One of the most common aspects of personal injury law is protecting people from their own insurance companies and other large insurance companies that become involved in legal disputes. After an individual is injured in an accident, they must file a claim with their insurers. While insurers often do make payments on claims related to personal injury accidents, other times they may:

  • inappropriately deny claims
  • make insufficient payments
  • delay payment
  • make unreasonable demands

Types of Insurance Claims

Every insurance company has a duty to deal with the individuals they insure in good faith. As a person with significant experience in insurance law, Wade B. Coye offers his clients a great deal of expertise and familiarity with handling insurance disputes. If you have been injured and are experiencing trouble finding compensation for your injury, contact our experienced insurance attorneys and legal staff for aggressive, personal service.

We handle disputes related to: 

  • Automobile Insurance
  • No Fault Insurance
  • Homeowners Insurance
  • Health Insurance
  • Life Insurance
  • Disability Insurance

Bad faith claims and insurance disputes can arise in any context, including personal injury accidents and incidents of property damage. At The Coye Law Firm, we take pride in helping individuals with any insurance dispute in and around Central Florida, from homeowner’s insurance to Personal Injury Protection (PIP) policies.

Bad faith insurance claims result when insurers wrongfully deny claims. Sometimes this occurs when the value of the claim exceeds the limits of the insurance policy. In other words, an insurance company may deny a claim, leaving the insured personally liable for verdicts in excess of the policy limits.

Other types of insurance claims involve an insurer’s refusal to honor the terms of the policy. Homeowner’s insurance, for example, is meant to protect individuals from liability for accidents that occur on the policy holder’s property. Many times, an insurance company denies payment, claiming that the damages which resulted were not covered by the policy. Your insurance claim may be a little more different than you think. Through contracts and terms and agreements, you may have signed an arbitration clause without even realizing it, which will require you to settle your dispute in binding arbitration outside of court.

 

1) Filing a claim

The first thing you want to do in the event of any accident or injury is report the information to your insurance company. It is highly important that you review your insurance policy so you are prepared and knowledgeable about the particulars of your insurance coverage. Remember that when speaking with the insurance company that you are being recorded on every call and the way you speak or words you say could come back against you later.

2) Attempt Negotiation

 

Insurance companies will often offer a settlement amount much lower than the amount you feel your claim is worth. This offer may be subject to negotiation and is usually not a firm number, so don’t feel that you must accept the first amount proposed. It may take several phone calls, or several pieces of mail, but you can attempt to negotiate an amount you feel is reasonable.

3) Report to Authorities

If the insurance company is still responding with a settlement offer which is a great deal less than the amount you research, or if the company denies your claim outright and you have reviewed your policy information and feel your claim is in good faith, gather your documentation and send copies of it with a letter to the Director of Claims of your insurance company by certified mail. At the same time, you can consider sending copies of this information to the Florida Office of Insurance Regulation (FOIR). The FOIR is the office which monitors and ensures insurance companies comply with Florida law.

If you have attempted these steps, and the insurance company is still not willing to negotiate a settlement amount you consider reasonable, or if they are continuing to deny your claim, it is time to contact an experienced Insurance attorney .

4) Dispute Resolution with Representation

Once you have decided to contact an attorney the resolution process will be taken over by them. for an example of this process in regards to a personal injury. Provide your attorney will all copies of documentation and information regarding your claim. Your lawyer will find need full disclosure of all information, including steps you have already taken and statements of verbal conversations with the insurance company, in order to efficiently process your dispute. There will be a few things to consider and expect once working with your attorney in order to expedite the process.

5) Continued Negotiation

If you are contacted by someone from the insurance company once you are under representation from an attorney, do not continue speaking with insurance adjusters. Politely refer them to our office and provide your attorney with any documentation you receive from them by mail. Your lawyer will continue the negotiation process on your behalf.

6) Prepare for Settlement

Your research may have provided you with a settlement amount which is your ideal, however you should discuss a reasonable minimum amount with your attorney. In the event that your attorney is successful in negotiating this amount for you, you should discuss with your attorney the particulars of settling the claim rather than pursuing further action.

7) Prepare for Lawsuit

Lawsuits involve several steps you should discuss with your attorney. Filing suit is a serious decision and should not be taken lightly.

Things to Remember Throughout 

Make sure that you keep records of dates and times you spoke with insurance claims adjusters and copies of all documents they send you. In a situation where there may be several options for repairing damages or obtaining treatment, such as in an auto accident or after a personal injury, it can often be worthwhile to obtain multiple estimates for repair or recovery. In the process of attempting to handle the insurance claim on your own, or in case of a dispute, this can be invaluable.

You should have in mind an amount that your claim is worth. For more information on determining this, you might have a look at this article. Document and keep your sources of research and how you came to this value. The amount needs to be both reasonable to the insurance company and sufficient to cover the expenses you are facing due to the accident, injury, or loss. The most difficult cases for calculating a reasonable amount are typically those involving personal injury and can often overlap with claims to health or auto insurance. If you need further assistance, or are dealing with processing multiple overlapping insurance claims, be sure to contact an attorney with the Coye Law Firm.

On Your Own

In some situations claims can be handled without the assistance of an attorney, such as a car accident in which no one was injured. If your case is more complicated you may be tempted to handle the insurance claim process on your own, but keep in mind that should you later decide to seek legal counsel, actions you took earlier in the process may act detrimentally to your claim. Insurance attorneys have experience in navigating the claims process and can help if you begin to feel overwhelmed. You have the option to contact an attorney at any point in the claims process for legal assistance and advice.

The experienced insurance attorneys at the Coye Law Firm are dedicated to providing aggressive representation to clients going through the process of insurance disputes. Contact us today for an evaluation of our ability to assist. 

 

Call 407.648.4940 or contact Coye Law Firm today for a free consultation about your case.

The expert injury attorneys at Coye Law Firm are experienced with Florida, New York, Michigan, and District of Columbia law and are here to help the injured.

If you'd like to learn more about injury law and your rights, read my book, Sharing the Secrets, Learning the Lies: A Guide to Florida Personal Injury.

>>Click here to receive your FREE copy now. 

From this book you will learn… Personal Injury Book for consumers

  1. The ONE THING you must do within 14 days of your accident (page 46)
  2. The two most important factors in determining case value (page 8)
  3. How to understand what your insurance will and will not cover (chapter 3)
  4. 6 critical steps you must take after an accident (chapter 7)
  5. Why you should not trust the insurance company’s repair shop (page 78)
  6. How to choose the right doctor (chapter 5)
  7. A claim you could make against your own insurance company if your car is damaged, but not totaled (page 87)
  8. The secrets to getting a fair settlement (chapter 10)
  9. An 8-step breakdown of the normal process for lawsuits (page 121)
  10. The one 4-letter word that might cost you (chapter 12)
  11. How to start gathering the most important evidence you need (page 75)
  12. …and more!

>>Click here to receive your FREE copy now.