In the business of insurance everyone will encounter different types of risk, one of which is the very common occurrence of having benefit claims denied. In some cases, the issue is easily resolved such as when there are documents or information that are lacking and all you have to do is comply with the requirements. In some instances, however, the best course of action is to get professional help from insurance lawyers in Toronto to properly find a resolution for the matter.
Insurance claims may be denied for many different reasons. Usually they are rejected when:
- Claims are filed too long after the date of service.
- The insurance company misplaced your claim and it did not make it into the system before the deadline.
- You have non-covered charges.
- Services were provided without the proper authorization.
- You used an out-of-network provider.
- There may be typos or minor data entry errors.
- Your claim may have outdated insurance information on file for you.
- The insurance company claims that the policyholder intentionally caused a loss.
- The insurance company claims it did not receive a premium payment on time.
Most people would like to believe that insurance companies will honor their obligations when a valid claim is made and that when there is a denial of a claim the insurance company can provide valid reasons for the denial. The truth of the matter is that insurance companies have a financial self-interest to not pay a claim. Payments made to insurers simply diminish the cash reserves that insurance companies must maintain to stay afloat. As a result, insurance companies often interpret policies to minimize required payments towards valid claims or, especially in some situations affecting large numbers of people or things, they simply refuse to pay.
Insured parties who may feel that the denial of their claim is unreasonable can always choose to file an appeal for reconsideration. You can choose to represent yourself in an insurance dispute, but hiring an insurance attorney with experience in insurance litigation and the nuances of interpreting insurance policies will prove to be more advantageous to you.
There are many benefits to getting an insurance lawyer in Toronto to handle your insurance dispute:
- The right lawyer can go through the policy and assist you in understanding the terms and conditions of your policy, in particular the critical conditions in the fine print that you cannot easily interpret that may have an impact on your claim.
- He or she can review the basic facts of your policy such as the potential worth of your claim, the deadlines you need to follow, and direct you in completing the documents or requirements you have to submit in order to properly file the claim under the policy.
- An experienced dispute insurance law attorney can help you file suit and litigate through trial on your behalf in the event you will need to fight the denial of your claim in court.
- Attorneys can help you determine the best course of action once your dispute turns into a legally complicated matter.
- An expert lawyer has handled many cases and will definitely have a standard process in collecting evidence and presenting them for evaluation in order to make sure you get the compensation you deserve.
When your insurance dispute becomes too difficult to handle, you don’t have to stress about your case and deal with the insurance company on your own. Working with insurance lawyers in Toronto can help relieve a significant burden on what to do next. They will be able to guide you on your legal options and help you figure out the best strategy to use to win your case.
