What do I do if the insurer rejects my claims

It is assumed that insurance should be a guarantee that we will receive compensation for losses suffered in the face of certain unfortunate events in life: a car or work accident, a fire in our home, the loss of a loved one, among others. It is not a secret that we usually acquire insurance, coverage, and policies in order to be prepared for the future and protect our families. But, unfortunately, when it comes to dealing with insurance companies, things are not always as they have promised, and therefore we plan and expect them to happen.

It is important to remember that an insurance policy is a legal contract between a person and an insurance company. The company is responsible for compensating the insured in cases of damage, injury or death. That is, the insurer must comply with its part of the deal. So when we file a claim with an insurance company, we expect the company to act in good faith and enforce our claim.

However, insurance disputes usually occur when an insurance company rejects a claim that is apparently valid, often without a legitimate reason or explanation. And, in many cases, they only investigate a claim if the insured initiates a legal action. Therefore, when this happens, it is necessary to take the case to the authorities with the help of a lawyer.

Types of most common insurance disputes:

  • Car insurance: After a car accident, one of the first things we must do is contact our insurer to start the claim. Car insurance should cover expenses for damages, etc.
  • Work accident insurance: Almost all workers are covered by compensation or labor compensation. Workers’ compensation is insurance paid by the employer that covers financial benefits and/or medical treatment for employees who are injured or become ill as a result of their work.
  • Life insurance: It is an insurance that should compensate the family of the person in case of death.
  • Home insurance:  This type of policy protects the home against damage from fires, earthquakes, hurricanes and other unforeseen events. The insurances vary as far as the events that cover depending on each company.

To learn about all the types of insurance disputes we handle, visit this post.

Why they reject my claim

Unfortunately, insurance companies often manipulate the language of their contracts to minimize or deny valid claims. These companies tend to protect their profits by avoiding having to pay the insured. The insurance companies hold as valid several reasons for rejecting a claim, such as the insured failed to pay his policy premiums on time, which caused the expiration of the coverage; that what happened to the insured is not covered by the insurance, among other excuses.

Remember: Keep in mind that almost all claims or claims made to the authorities have a deadline and time limit to be presented. In another post, we explain better about the subject of what is known as the Expiry Term.

Some tips to keep in mind

As it happens to us when we look for a lawyer for a legal problem, having to find the right insurance company is not an easy task either. It is key that we know who we are going to trust our future and the welfare of our family. For this, you can follow any of these tips:

  • Acquire insurance policies from well-known companies with a long history in the business.
  • Research the different insurers on the Internet, news, and reports.
  • Ask your acquaintances to recommend a trusted company.
  • Do not stay with any doubt. The insurance agent will try to sell you the policy yes or yes, so ask him about all the details of the insurance policy: what are the procedures to make the claim, what exceptions and types of insurance coverage and other relevant matters.   
  • Read the complete contract, the clauses, and even the fine print.
  • Carefully save the contract, keep email exchanges with the company, notes and payment invoices.

Consult with our lawyers

If you are in insurance disputes with a company or have a claim that was rejected, contact us today for a free consultation in Spanish. Remember that there is an expiration period to start legal actions in this type of case. The earlier you start with the procedures, the more and better your chances of recovering everything you lost.

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