What is a Claim Dispute?

dispute insurance claim

What is a Claim Dispute?

Are you involved in a claim dispute? Claim disputes are more common than you would think. Claim disputes occur because an individual and an insurance provider have a disagreement. The dispute could be over medical bills, home repairs, damage to the home or car, what needs to be done and how much it costs, and much more. A dispute could occur over which part of the claim is covered by the insurance provider. It’s crucial for people to understand that this process is rarely fair. The insurance company has a lot, if not all, of the power. Insurance dispute claims usually involve technical and legal issues.

How Do I Dispute an Insurance Claim Denial?

Are you wondering where to start on your insurance claim dispute? Please feel free to read over the following list to discover more about this important process.

  1. Review the claim. The evidence that has been provided to support the claim has a huge impact on the kind of coverage that is extended. Looking at the insurance paperwork, see if any of the damage is covered in any of the articles. By increasing the amount of documentation that is submitted that is relevant to the claim, individuals have a higher likelihood of fairness when it comes to the coverage amount.
  2. Contact the insurance agent. After analyzing and submitting further evidence to support your insurance claim, speak with your insurance adjuster. At this point, it’s important to remember that an adjuster from the company calculated the estimate, not the agent who you will be speaking to themselves. Be cordial and listen to what they say.
  3. Ask if the claim can be reviewed again. Submit that you have new evidence for the claim, and outline any relevant articles in your contract. Perhaps a mistake was made by the adjuster. Mistakes happen. Ask for another review. After another review is made, the settlement number may not change.
  4. Consider an independent appraisal. If your insurance company still refused to change the settlement amount, it’s important to seek out other options. Be sure to select an insurance adjuster who is affordable and located in your area.
  5. Your last option is to file a complaint and hire an attorney. This course of action should be undertaken if the claim amount is high enough.

How Long Do I Have to Dispute an Insurance Claim?

After the incident, an individual has two years to settle a car accident case. If the individual is not able to settle the case within that two year time period, then they will have to file suit to preserve the claim. In the state of Indiana, an individual has 180 days to file a Notice of Claim to protect the individual’s right to file a lawsuit when a government entity is involved. 

How Do I Complain About an Insurance Claim?

You have a right to be upset about the result of an insurance claim. Please review the following bullet points to learn more.

  • Compose a letter. All insurance consumer complaints against insurance companies must be received in writing. 
  • Two ways. There are two ways that a complaint can be submitted to the IDOI. There is an online form that is available, or the form may be printed off and mailed or faxed to the Consumer Services division.
  • 72 hours. The complaint that is filed will be processed within 72 hours of receipt.

Can an Insurance Company Refuse to Pay a Claim?

As previously mentioned, dealing with the insurance company is not necessarily a level playing field. While an individual may have a valid claim, many insurance companies have a “deny first” policy. This is particularly true for larger claims. Persistence is key. An individual can file an appeal several times. It is important for each of these processes to have appropriate and accurate documentation. The stronger and more numerous the documentation, the harder it is for the insurance company to dismiss the appeals out of hand.

When to Dispute Insurance Claim

If you need 2nd opinions and dispute insurance claim help, it’s important to know where to turn. Insurance of all kinds is regulated independently. Insurance is regulated by each of the states and by the District of Columbia. While it is true that there are slight differences between each of the states, there are a few underlying principles that unite the regulations. For instance, insurance companies must precisely represent what is in the policy. Insurance companies are forbidden from asking an individual to fill out unnecessary paperwork in order to have the claim processed.

How to Dispute Insurance Claim Settlement

As previously mentioned, there is a rigorous protocol that must be followed. To begin with, the claimant must review the policy thoroughly and locate exactly the terms that apply to the claim. Next, he or she must find, locate, and create evidence that supports their claim. There is an appeals process, which can be used to justify the claimant’s need for more financial compensation for their damages.

Dispute Letter for Health Insurance Claim

If you are writing a claim appeal letter, it’s integral that you supply all your evidence and documentation. The letter must be addressed to the director of claims unless an exception applies. The situation must be described in your own words, and you must be persuasive in determining how the procedure should be covered. The evidence must be presented in an accurate and thorough manner.

dispute insurance claim

Building Insurance Claim Dispute

While it is true that managing your insurance company or the adjuster can be frustrating and time-consuming, it’s worthwhile for you to get the coverage you need for your damages. Please be sure to follow all the recourses available.

Scheduling an appointment to dispute insurance claim has never been easier. Our staff at Hope Public Adjusters are ready to take your phone call at 833-312-5246. Discover more about how we can help you dispute insurance claim in Indianapolis, IN!