Denied Or Underpaid Insurance Claims In California

Denied insurance claims in California.

When you’ve experienced property damage as a result of a devastating fire, flood, or other catastrophic events, your insurance benefits are supposed to help alleviate the financial stress that comes with having to repair your property. If you’ve submitted an insurance claim that was denied, or the settlement amount is less than you were expecting, it can feel like another devastating loss. If your insurance claim is valid, but it has been denied or underpaid, there are steps you can take to dispute your insurance company’s decision.

If you’ve never filed an insurance claim before, you might have been unaware of critical steps in the process. If your claim was filed incorrectly, you were at a disadvantage without even knowing it. However, hiring a public adjuster to deal with an underpaid insurance claim or a denied one can help to level the playing field, and you’ll have the help of a knowledgeable and experienced professional to aid you in your dispute. At ClaimMax Adjusters, our job is to first and foremost be an advocate for our clients. We know how insurance companies work, and we will fight for you to ensure you are fully compensated for your loss. We are experts in our field, and we are here to help you understand and know your rights.

Contact us today to learn more about how we can help with denied or underpaid insurance claims.

 

What are the Most Common Reasons a Claim Might Be Denied or Underpaid? 

It’s a common understanding that insurance companies try to pay the bare minimum on many occasions, but often, it’s not easy to admit that errors on behalf of the policyholder led to that happening. Usually, the person making the claim makes a small error, and the company leverages that to deny the insurance claim or underpay it

Three common reasons include failing to pay a premium on time, not filing the claim within the contractually agreed upon claim period, and suspected fraud. However, with some types of insurance, there might be a problem with documentation, you might not have appropriate receipts such as with medical insurance, etc. 

The failure to pay premiums on time is a common one, and it’s written into most insurance contracts. It’s also important to keep your own documentation for every payment to combat claims that you missed. 

The claim period is also a serious matter. Whether it’s 30 days or 90 days, there is a limit to how long you can wait after an incident to file a claim. If a flood occurred 3 years ago, and you’re just now filing a claim, much of the damage might have stemmed from neglecting the situation, and the insurance company will likely deny it. 

Then, there’s the suspicion of fraud. Sometimes, home or business owners intentionally burn down their property or do something else to get a fraudulent insurance claim started. However, insurance companies often use this fact to find any odd detail and accuse you of fraud. That’s why it’s important to cover every detail of the incident, the resulting damage, and any other relevant details when presenting your claim. 

Underpaid insurance claims in California can also occur because of these things, or you might not provide enough information; making it easier for the insurance company to downplay the damage and the repair costs. 

In general, it is best to remember that an insurance company is a for-profit business, and it makes its profits by paying out as little as possible by any means possible. You have to ensure you’re doing everything correctly when dealing with an insurance company.

 

How to Start the Insurance Claims Process After Being Denied

We’d love to say that once you start the claims process that it’s just a waiting game, but the reality is you’re likely to get denied if it’s at all possible. 

Luckily, you don’t have to accept the denial. You can fight it and restart the process

The best way to do this is by immediately contacting a claims adjuster. A ClaimMax Public Insurance adjuster’s job is to evaluate your situation independently of the insurance company and ensure that you’re handling your claim properly for a maximum payout. You’ll need your policy, the documentation you’ve received from the insurance company during the first attempt, evidence of the damages you’re claiming, and of course, any documentation related to expenses or losses caused by the incident. 

If you’re challenging a denied insurance claim, or you were underpaid for an insurance claim, it can also be a worthwhile strategy to higher an insurance attorney willing to fight for you.

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