When Do Insurance Coverage Disputes Arise?

Insurance claim lawyers in a meeting.

People invest a lot of money, time, and effort so they can live comfortably, but anything can go wrong at any time. A claim can frequently be made with the insurance provider when someone experiences loss or damage to their person or property. When someone is faced with challenging circumstances, insurance is supposed to help them recover.

However, you may disagree with the insurance provider about what your policy covers and the amount being provided to settle the claim. Insurance companies can be less inclined to pay a claim when a lot of money is at stake. You can dispute claims with any of your insurance providers, but disputes can be challenging to resolve. Whenever you are having trouble resolving an insurance dispute, it may be in your best interest to speak to a lawyer experienced with insurance litigation. 

When the Insurer Alleges They Don’t Cover a Particular Issue

Insurance coverage disputes are arguments between an insured party and their insurer over matters related to a claim. Though most insurance claims do not lead to a dispute, there are several different ways insurance coverage disputes can occur. 

A common situation that leads to insurance coverage disputes is the denial of a claim. An insured party asks their insurance provider to pay for any damages covered by a policy. However, the provider responds that the insurance doesn’t cover the particular problem, which may lead to a dispute. A claim of non-coverage may result from the insured breaching their policy, a failure to understand the coverage, or misunderstanding the policy.

When the Insurer Rejects the Insured’s Claim

Insurance disputes can also develop when a party files a claim with an insurance provider, but the provider rejects the claim outright. The insurance provider may be able to offer good reasons for the rejection, such as a contract breach or misinterpretation. However, the insured party may believe that the denial was unjustified, and the insurer may be acting in bad faith, resulting in a dispute.

When the Insurer Declines to Provide a Specific Level of Coverage

Different insurance policies offer varying levels of coverage for incidents, depending on the provider, the type of incident, and your monthly payments. Some disagreements occur when an insurance provider declines to provide a specific level of coverage or asserts different values than what a person is legally entitled to under the terms of the policy. When insurance providers fail to provide coverage at the value the insured needs, it could leave them struggling to make up the difference.

How Are Insurance Coverage Disputes Resolved?

Arbitration is frequently recommended as the initial step in handling insurance disputes as it creates a space where the matter can be discussed peacefully. In arbitration, you are talking to your insurance provider and with an unbiased third party, present to help keep the focus on a resolution. If successful, this will save money on legal fees and time-consuming courtroom trials. 

During the arbitration, a settlement is frequently achieved. Even if arbitration is the less expensive and unpleasant alternative, you have the right to reject it if your insurance suggests it. If you are unable to come to an agreement through arbitration, litigation may be necessary. 

In this situation, consult legal counsel and an experienced insurance claims attorney to assist you. The court will take into account the supporting evidence offered by both you and your insurance. After examining this evidence, the court will make a ruling, and this decision will be legally binding.

Resolve Your Dispute With the Help of an Experienced Insurance Coverage Attorney

You have the option to first negotiate with their insurance provider when they offer an unreasonable settlement. You can also try to settle your insurance problems by submitting an appeal or contacting an insurance representative. However, sometimes, trying to resolve a dispute on your own can result in little to no progress. The wisest course of action may be to consult an insurance coverage attorney. 

You may be able to settle your dispute with help from the Law Office of Robert H. Hanaford. For the last 38 years, Attorney Hanaford has spent his legal career fighting for the rights of people in Florida just like you. He has a long history of success in winning his clients’ cases in difficult trials. Call (239) 315-9750 or submit a contact form to make an appointment for a free case consultation.

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