Tip 1 -- Don't assume NO is final
Did you know that less than 1% of claimants query the decision when a claim is denied? Yet, over 50% of those who do fight back get results.
So, you've got a good chance of winning if you fight back.
10% of claims are unjustly denied, so if you are aware your claim is legitimate, and you've not indulged in any creative claiming, you have a good chance -- even if they've said no.
It's also a fact that most claimants who query their claim end up with a better settlement... or having a denial reversed!
Tip 2 -- Get It In Writing
Insist on a review of the case, and a written comprehensive explanation of the reasons for rejecting the claim. It's surprising how many insurers don't give their "no" in writing, and it may be a legal requirement where you live.
Tip 3 -- Now Check Your Policy
Once you have it in writing, check the reason for denial against your policy. Look for ANYTHING that doesn't add up or make sense. Then query this in writing, referring to quotes from the policy where necessary.
Many claims come down to interpretation of the policy, so a good case explaining why you believe your claim is valid may lead to reconsideration.
Tip 4 -- Never Accept Claims Process Errors
The insurer will have a claims process or filing process. For example, you need to file the claim within a certain window of time. The insurance company may deny your claim (or try to) just because you filled in a form incorrectly, or didn't file within the designated time limit.
An insurance company cannot usually refuse to pay a claim that is otherwise valid just because of a claim filing error in most legal jurisdictions, unless it can show that your error either harmed the company, or prevented it from investigating adequately.
(BTW, each country and state has its own regulations about claims and responding to them, so do check your own location's rules and regulations before implementing the ideas on this list.)
Tip 5 -- Try Asking Your Agent For Assistance/Advice
This isn't frankly very likely to do any good, but you never know until you try. They may be able to help, or to direct you to the right people to contact for the following tips...
Tip 6 -- Call The Authorities
In the US, call the State Insurance Department or the Department of Insurance. In the UK, the Insurance Ombudsman. Wherever you are, check first with the legal authority that governs insurance about what your rights are.
Tip 7 - Secure an Agent
Actors and writers use agents to represent them in the marketplace. Insurance companies also use agents so they don't have to deal with you personally.
Consider hiring an agent to represent you in the claim. Good agents will pay for themselves in major claims.
Many people aren't aware that these agents exist. For example, in the US they may be called "Professional Loss Consultants" and charge a fee of about 10-15% of your claim. They know how to deal with insurers and claims, and may increase your claim for you if they are brought in early enough (which may cover their fees). If you've already made a claim and lost, they may still be able to help.
But beware of "no win no fee" arrangements: before signing, attractive though they may sound, check what the fee WILL be if you win -- and who will pay. Otherwise you may find your winning claim is eaten away by the agent's legal costs.
Tip 8 -- Consider a Lawyer
If you really want the insurance companies to sit up and take notice you should bring in a lawyer that specializes in insurance claims - like The Voss Law Firm.
Tip 9 -- Be Persistent
Telephone the company regularly -- every 2-3 weeks. Be polite, but be persistent. Keep asking for the person's supervisor or manager if you don't get a suitable response.
Log all phone calls, with the date, time and names of the people you spoke with. Follow each call up with a letter explaining the conversation and the issue you have with it, and ask for a written response within 14 days. Then call again if/when you don't get a response.
It goes without saying to also keep copies of all letters you send, and send everything by certified mail with return receipt.
We obviously can't guarantee that these tips will get your claim paid out, but they certainly can help.
And remember, less than 1% of people query a rejected claim, yet over 50% of those who do get somewhere!
