How to Handle an Insurance Dispute

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Insurance mistakes or errors are not uncommon. Insurance disputes may include situations such as inaccurate billing, a company’s payment on a claim, and nonpayment of a claim. In some cases, they may be minor and resolved quickly with a simple call or letter. However, more complex and significant issues can be difficult to resolve. Insurance policyholders should always be aware and vigilant of the terms of their contracts, policies, and agreements. This allows policyholders to be more equipped and prepared when issues occur, which in turn increases the chances that an issue will be fixed quickly and fairly. Policyholders who are unhappy with an incident or outcome should follow certain steps to handle an insurance dispute.

Using an Insurance Broker or Agent

Policyholders who have an insurance broker or agent may benefit from using him or her as a resource to resolve the disagreement amicably. Insurance agents and brokers already have established relationships with the company. This can help to resolve disagreements quickly. Policyholders should contact their insurance broker or agent and provide him or her with all the necessary documents to support the issue. If policyholders do not have an agent or broker, they should contact the insurance company’s customer service department to discuss the issue.

Writing a Letter

If the issue is still not resolved after contacting an agent or customer service representative, the policyholder should consider writing a letter an appropriate manager within insurance company. In this letter, the policyholder should clearly state the issue and propose a fair resolution. The letter should include records of past conversations regarding the issue, such as dates of customer service calls and names of representatives spoken to. The letter should also include documents that support the issue, such as bills, correspondence, and cancelled checks.

Involving a Third Party

In the event that both previous tactics have failed to resolve the issue, policyholders should consider involving a third party. State insurance regulators may help to investigate the dispute. If the state finds that the insurance company has violated any regulations or laws, the company may be penalized. Other third parties that may impact a dispute include the Better Business Bureau and the state consumer protection division.

Taking Legal Action

Policyholders who still see no results may be able to file a lawsuit against the insurance company. Depending on the amount of money in question, the claim may be heard in small claims court. When policyholders have exhausted other options, they should hire an experienced insurance attorney to begin the legal process. An insurance lawyer can help to organize a case and advise which course of legal action will best suit the policyholder.

 

 

Sources:

http://www.360financialliteracy.org/Topics/Insurance/General-Insurance-Topics/Handling-a-Dispute-with-Your-Insurance-Company

http://www.cfah.org/prepared-patient/pay-for-your-health-care/handling-an-insurance-dispute

David Paul
David Paul
David Paul is known for his compassion for his clients and his dedication to fight for the truth, even against overwhelming odds. Board certification recognizes attorneys’ special knowledge, skills and proficiency. David is one of only seven Plainitff’s lawyers in Orlando to be a Board Certified Civil Trial Lawyer with both the Florida Bar and the National Board of Trial Advocacy. Board certification is the highest level of evaluation by The Florida Bar of the competency and experience of attorneys.