We hear this from clients often: “I want to wait to see if my insurance company does the right thing.” This is often the case even when the insurance company has already refused to pay all or part of their claim, wrongfully. Unfortunately, many policyholders believe if they push their insurance company too hard, if they anger the adjuster, this allows the insurance company to deny their claim—like a child taking his toy and going home. That's not how it works. As a policyholder you have rights, and emotions have no impact on your insurance company's contractual obligation to pay you. Here are three reasons why you should push on your insurance company to pay your claim or hire an insurance attorney to help you, rather than wait to see if they will do the right thing.
1. While you wait, they are often gathering evidence to deny your claim
It is important to remember while an insurance claim may be a rare occurrence for you, it is everyday procedure for an insurance company. Once you give them notice of a loss, they immediately snap into claim-adjustment mode and begin investigating. All too often they immediately look for reasons, excuses really, they will try to use to wrongfully deny all or part of your claim.
If you've been injured in a car accident, the insurance company often scours your medical records looking for pre-existing injuries or complaints of pain to say your current aches and medical problems are not related to the accident. If your home is damaged in a fire or storm, they often search your house or maintenance records for signs of pre-existing wear and tear to say the storm did not cause the damage, it was already there. Unlike you, insurance companies are very good at this game and know exactly where to look for this type of evidence, who to question, and what documents to gather to support their decision to deny your claim. This excuse-gathering will likely occur all while you are waiting for them to “do the right thing.”
2. While you wait, you may be unknowingly failing to meet your obligations under the policy
Many policyholders do not read their policies and are not aware of obligations they have under the policy. Some of these obligations, if not met, allow the insurance company to deny coverage. Depending on the policy, these can include the obligation to file a sworn proof of loss within a certain timeframe after the loss, provide an itemized list of damaged personal property, submit to an examination under oath or independent medical exam. The more time that passes while you wait for the insurance company to “do the right thing” without having an experienced attorney looking out for you, more of these time-sensitive obligations may pass without your knowledge. The only one who will benefit from you allowing time to pass is the insurance company as they hope you unknowingly miss an obligation which will give them a reason to deny coverage.
3. While you wait, you may incur more damage than you would have otherwise
The most important thing that needs to occur after a car accident or damage to your property is getting you back in the place you were in before the loss occurred. In a property damage case, the longer your home or building sits unrepaired, the more costly the repairs may be as the property continues to deteriorate if exposed to weather, water, mold, or other detrimental forces. In a car accident case, if you are trying to work and care for your family while in pain and/or limited in your abilities, a growing pile of unpaid bills is only going to make your situation more difficult and more costly to get back to where you were before the accident. Waiting for the insurance company to “do the right thing,” while your damages are increasing, serves no purpose. The insurance company is contractually obligated to pay what is owed under the policy no matter how many times you email or call or whether you hire an attorney to help you. The only person who is harmed by you waiting and worrying you might irritate the insurance company is you. Pushing, pestering, or even irritating the insurance company has absolutely no impact on their duty to pay. More often than not, it is required to get the insurance company to pay you what you are owed in full.