Insurance Claim Disputes

Insurance Claim Disputes often arise when an insurer denies or refuses to pay all the amounts due in response to a claim from the policyholder or in relation to a lawsuit against the policyholder. Insurance policies and the law relating to insurance is complicated and sometimes difficult to understand. Policyholders are often entitled to more rights and benefits than the insurance company is willing to acknowledge. After all, it is an insurance company’s interest to resolve a claim for nothing or as little as possible. Attorney Floyd has spent years handling insurance issues ranging from coverage disputes to the wrongful denial of benefits.

What Type Of Insurance Claim Matters Does Your Firm Assist Clients With?

Usually it’s either a catastrophic or significant loss and the Client is concerned about the claims process or how they have been treated by their insurance company. My office also assists Clients who have had a claim denied or were sold insurance that does not provide the coverage that they thought they were purchasing. A good example is a restaurant or bar that buys a liability insurance policy and the agent includes a policy that excludes coverage for dram shop liability, which is liability that stems from the overserving of a patron who in turn injures someone or something else. Dram shop liability is one of the largest risks that a restaurant or bar faces as part of its business. So, in that scenario the insured bought an expensive insurance policy that doesn’t cover their primary risk and the insurance company later denies a claim based on that exclusion.

How Common Is It For Insurance Companies To Deny Claims? Why Do Insurers Delay Or Deny Claims?

Insurers routinely deny claims. Insurers do not make money by paying out claims; they make money by collecting premiums. They also make money when the payment of a claim is denied because they continue to hold onto the money and hope the value of the claim will go down or rely on other factors that allow them to profit by withholding paying a claim. South Carolina Law recognizes this aspect of the insurance business and has created safeguards to protect policyholders and help them seek compensation when an insurance company treats them unfairly or unreasonably.

Is Underpayment Or Delay In The Payout For A Claim Grounds To File A Lawsuit?

If the only issue is a small underpayment or short delay, then it typically will not warrant a lawsuit. However, there is a potential for a claim and it may warrant filing a lawsuit when the underpayment is significant and/or the delay is clearly unreasonable.

Should I File A Claim On My Own First Or Should I Hire An Attorney To Assist In Filing A Claim?

Oftentimes, it depends on the complexity of the situation. Consulting with an attorney before filing a claim is ideal, especially where the loss is significant, which typically means it has the potential to exceed one hundred thousand dollars ($100,000.00).

How Do You Advise Clients That Want To Handle Insurance Claims Without Assistance Of Legal Counsel?

I explain to people all the time that insurance is way more complicated than people think. I also ask them if they have ever actually read their policy and whether they honestly understand it. I also remind them that dealing with an insurance company (even their own) is almost like David versus Goliath and you are not Goliath. There are a lot of rules outside the policy that a policyholder simply will not know about when dealing with insurance companies and some of those rules actually help a policy holder.

What Are Some Potential Resolutions To Insurance Disputes? Will I Have To Go To Court?

Occasionally, insurance disputes can be resolved without a lawsuit. However, there is a good chance a lawsuit will be necessary, although it can get resolved prior to a trial through a settlement.

For more information on Insurance Claim Issues In South Carolina, a free initial consultation is your next best step. Get the information and legal answers you are seeking by calling (803) 361-4812 today.