Many of us have shared the same experience: Purchasing a new home and choosing a specific policy with a property insurance company to ensure that any damage done to the house is covered by our policy instead of having to be paid out of pocket. In some instances, policyholders have to sign over benefits to repair contractors, who are then supposed to submit receipts directly to the property insurance company. However, it is a common complaint amongst homeowners that insurance companies will routinely deny these types of claims unfairly or offer too little in compensation for the repairs that have been done.
If your insurance company denies your claim or fails to respond to your questions about a claim, speaking with an experienced insurance attorney may provide you with some viable options. Our attorneys offer free consultations and discuss, in detail, how we can help you. Contact us today.
An Assignment of Benefits applies to most-all insurance company contexts; it is a legally binding agreement that you sign with your property insurance or health insurance company asking that they send reimbursements for services rendered (that are covered under your policy) directly to the party who provided the services, whether that is a repairman, doctor, or other professional.
While this type of policy typically involves professionals waiting up to a month or so for reimbursement, unfortunately, it has also been the subject of abuse by the insurance companies themselves in the form of delayed payments or outright denial. Insurance companies sometimes appear to deny claims more frequently in these instances, or sometimes provide reimbursement for less than an appropriate amount for a given repair or service.
Sometimes insurance companies will also try to raise rates, or mandate that certain steps be taken in order to prevent claims in the first place (thereby denying a claim outright if those steps aren’t first taken); for example, mandating that policyholders must take emergency measures to protect property from further damage and/or limiting how much they will reimburse for costs without first approving additional measures. They can also set up additional rules and requirements before they cover damage, such as denying reimbursement for permanent repairs that begin before a certain number of hours after the loss is reported to the insurance company, or first require that there be an inspection done by that specific company or that the company provide explicit approval before any work is done to address a loss.
For example, if a home faces plumbing damage, the insurance company might “clarify” that, while it will cover the access required to replace the aspect of the system that caused the loss, they will not cover the aspect of the system that was not affected by the specific covered loss.
Many policyholders have complained and consulted bad faith insurance attorneys about what they call artificial repair limits and restrictions on permanent repairs that are unreasonable. The elimination of certain contract rights, rate hikes, and other changes typically need to first be reviewed by each state office of insurance regulations, however, policyholders often aren’t first given the right to voice their concerns before such changes are approved.
This issue may be more prevalent than you think; if you’ve yet to file a claim for property damage, you may not realize why people sometimes prefer to go with their own contractor and have that contractor get reimbursed by the insurance company. In fact, many property owners feel that by having their own contractor examine a particular issue (instead of someone with the insurance company), they will receive a more objective opinion on the cause of the problem itself.
Perhaps unsurprisingly, insurance adjusters are often more likely to conclude that a particular issue is not actually covered by a given policy, and by simply listing a different cause for the damage they can shift the blame from an occurrence that is covered, to one that is not. And even if a given problem is covered, it is always possible that they could underestimate the seriousness and cost of repairing it.
Our bad faith insurance attorneys have spent many years dealing with cases where insurance companies are denying claims simply to increase their own profits. Our first approach isn’t to jump into litigation, but rather, to approach your insurance company and engage in serious communications with them in an effort to reach a reasonable result. However, if the company continues to behave unreasonably, filing a lawsuit and seeking damages can sometimes be the only way to ensure that justice is served.
We’ve served many clients throughout the state in seeking justice for the policies they’ve been paying for and the benefits they deserve. With an office based in Tulsa, we also travel to our clients if that is more convenient for them. Contact us online or call the Bennett Law Firm, at 405-272-0303 to schedule a free consultation, and we’ll get started discussing your options with you.
