What Do You Do When a Health Insurance Company Denies Your Claim?
When an insurance company denies your claim, the aftermath can be stressful, frustrating, and financially draining. You may feel abandoned by a system that was supposed to protect you in times of loss. Whether you’re dealing with property damage, health expenses, or denied coverage after an accident, it’s easy to feel like you’re facing an uphill battle.
Individuals and families rely on their insurers to honor the promises made in their policies. Unfortunately, when valid claims are rejected, many policyholders don’t realize they have legal options.
Suing an insurance company may seem intimidating, but with proper legal guidance, it’s possible to hold them accountable and recover what you’re owed. Lake Worth Beach, FL insurance litigation attorney Jeffrey Liggio can help you pursue justice after wrongful denials. Reach out to Liggio Law today to discuss your claim and learn how we can help.
Why Insurance Companies Deny Valid Claims
Insurance companies are profit-driven businesses, and their primary goal is to minimize payouts whenever possible. While some denials are justified by policy exclusions or insufficient documentation, many rejections stem from internal tactics aimed at protecting their bottom line.
Common reasons for denied claims include:
Alleged policy exclusions: The insurer claims the loss isn’t covered under your policy.
Insufficient documentation: The company states that key records or proof were missing.
Missed deadlines: The claim is denied because it wasn’t filed within the required timeframe.
Bad faith conduct: The insurer unreasonably delays, underpays, or rejects legitimate claims.
When you receive a denial letter, reviewing it carefully is crucial. Some insurers rely on confusing language or broad interpretations of policy clauses to discourage further action. An insurance litigation attorney can help identify whether the denial was lawful or the result of bad faith.
By contesting the denial early, you preserve your rights and strengthen your position if litigation becomes necessary later.
What Constitutes Bad Faith In Insurance Claims?
Insurance companies are legally required to act in good faith toward their policyholders. This duty means they must treat you fairly, evaluate your claim promptly, and communicate honestly throughout the process. When they fail to meet these standards, it may amount to bad faith conduct.
Examples of bad faith include:
Unreasonable delays: The insurer repeatedly stalls or ignores communication.
Failure to investigate: The company rejects the claim without a proper review.
Lowball offers: The insurer offers far less than the claim’s true value.
Misrepresentation: Policy terms or coverage limits are intentionally distorted.
If you suspect your insurer acted in bad faith, legal recourse is available. Working with an insurance litigation attorney helps you uncover evidence of misconduct, file a formal complaint, and pursue compensation beyond the value of the denied claim. In some cases, additional damages—such as emotional distress or punitive damages—may apply.
Steps To Take Before Suing Your Insurance Company
Litigation isn’t always the first step. Before filing a lawsuit, there are several actions to take that can either resolve the dispute or strengthen your case.
1. Review the denial letter:
Carefully read the reason your claim was denied. Insurance companies must explain their decision in writing, referencing the specific policy provisions they relied upon.
2. Collect supporting evidence:
Gather all related documents, such as photos, receipts, medical reports, and correspondence with the insurer. The more evidence you have, the stronger your argument becomes.
3. Request an internal appeal:
Most insurance policies include an internal review process. Submitting a formal appeal allows the company to reconsider its decision, potentially avoiding the need for court involvement.
4. Consult an insurance litigation attorney:
A qualified attorney can review your case, evaluate the insurer’s actions, and determine whether you have grounds for a lawsuit.
Taking these preliminary steps demonstrates diligence and can reveal whether your insurer is open to negotiation or is acting in bad faith.
What To Expect When Filing An Insurance Lawsuit
If informal appeals fail, litigation may be necessary to compel your insurer to act fairly. The process can vary depending on the type of claim and policy, but several key stages typically apply.
Filing The Complaint
Your insurance litigation attorney will draft and file a complaint detailing the insurer’s wrongful conduct, the nature of your losses, and the damages you seek. This document officially begins the lawsuit.
Discovery Phase
Both sides exchange evidence and information related to the case. This stage often reveals internal communications, reports, and policy documents that may expose misconduct.
Settlement Negotiations
Many cases settle before trial. Your attorney may negotiate directly with the insurer to reach a fair resolution. If a settlement can’t be reached, the matter proceeds to court.
Trial And Judgment
During the trial, both sides present arguments, witnesses, and evidence. If the judge or jury rules in your favor, the insurer may be ordered to pay the full value of your claim, as well as additional damages for bad faith.
Throughout the process, an insurance litigation attorney provides crucial guidance, manages communications, and safeguards your legal rights.
Types Of Insurance Claims That May Lead To Litigation
Not all insurance disputes are the same. Lawsuits often arise across multiple policy types, each with unique challenges. Some common examples include:
Homeowners insurance claims: Denials related to fire, water, or storm damage.
Auto insurance claims: Disputes over coverage limits or fault in accidents.
Health insurance claims: Rejections of necessary medical treatments or procedures.
Disability insurance claims: Wrongful denials based on misinterpreted medical evidence.
Life insurance claims: Delays or refusals to pay beneficiaries after a policyholder’s death.
An insurance litigation attorney familiar with these areas can assess your specific situation and tailor a strategy that fits your policy type. Each case requires careful review of contract language, correspondence, and timelines to uncover potential breaches of duty.
Potential Outcomes Of Suing Your Insurer
The results of an insurance lawsuit depend on the evidence and the insurer’s behavior. Successful cases can result in more than just a payout; they can also create accountability and change how insurers treat future policyholders.
Possible outcomes include:
Payment of the denied claim: Recovering the full amount you were originally owed.
Interest and penalties: Compensation for financial harm caused by the delay.
Attorney’s fees: In some cases, the insurer may be required to cover your legal costs.
Punitive damages: Awarded when the insurer’s conduct is especially egregious.
Even if a case settles before reaching trial, it often leads to a favorable financial outcome for the policyholder. Partnering with an insurance litigation attorney increases your chances of achieving a fair resolution.
How Long Does An Insurance Lawsuit Take?
The timeline for an insurance lawsuit can vary based on several factors, such as the case’s intricacy, the amount of evidence involved, and the insurer’s willingness to negotiate. While some cases resolve in a few months, others may take over a year.
A typical timeline includes:
Initial consultation and filing: Weeks to prepare and submit documentation.
Discovery phase: Several months to exchange evidence and conduct depositions.
Settlement discussions: Ongoing throughout the case.
Trial: If no settlement is reached, the case moves to trial for resolution.
Throughout this process, communication between you and your insurance litigation attorney remains essential. A good attorney will keep you informed, explain developments clearly, and guide you through each stage with confidence.
How An Insurance Litigation Attorney Helps You
Suing an insurance company can be intimidating without professional guidance. An experienced attorney brings knowledge, strategy, and advocacy to your side.
Key ways an insurance litigation attorney helps include:
Evaluating your claim: Determining if the insurer acted in bad faith or violated policy terms.
Managing communication: Handling all correspondence to avoid missteps or coercion.
Gathering evidence: Subpoenaing internal company documents or expert witnesses.
Negotiating settlements: Seeking the best possible outcome before or during litigation.
Representing you in court: Presenting a strong, well-documented case before a judge or jury.
Having an attorney who understands how insurance companies operate helps level the playing field. Whether your insurer has ignored, delayed, or undervalued your claim, a lawyer can help you take decisive action.
Why Florida Policyholders Should Act Quickly
Florida law imposes specific deadlines for filing lawsuits against insurance companies. Missing these deadlines—known as the statute of limitations—can bar you from seeking compensation entirely.
Acting promptly after a claim denial allows your insurance litigation attorney to:
Preserve critical evidence before it’s lost or destroyed.
Interview witnesses while memories remain fresh.
File necessary legal paperwork before deadlines expire.
Delays benefit the insurer, not you. If you’re in Lake Worth Beach, FL, contact a lawyer as soon as your claim is denied to discuss your options. Early intervention often leads to better outcomes and stronger cases.
Contact An Experienced Lawyer
At Liggio Law, insurance litigation attorney Jeffrey Liggio proudly serves clients in Lake Worth Beach, Florida, helping policyholders pursue justice after unfair claim denials. Our firm takes on powerful insurance companies and fights for those who’ve been wronged.
If your insurance company has denied your valid claim, don’t wait another day. Reach out to us at Liggio Law to schedule a consultation and discuss your case with Jeffrey Liggio today. We’re ready to help you move forward with confidence.