As a business owner, facing a denied or underpaid insurance claim can be disheartening and stressful. Insurance is meant to be a safety net, ensuring your business can recover from unforeseen events. However, disputes with insurance companies are not uncommon. This guide will help you navigate the steps to take if your business insurance claim is denied or underpaid.
At the Saxton Law Firm, our Missouri small business attorneys guide you through the legal process anytime you have a dispute with an insurance company.
10 Steps to Take if Your Business Insurance Claim is Denied
1. Understand the Denial or Underpayment
The first step is to thoroughly review the denial letter or explanation from your insurance company. Understand the specific reasons provided for the denial or underpayment. Common reasons include:
- Lack of Coverage: The incident is not covered under your policy.
- Policy Exclusions: Specific exclusions outlined in your policy.
- Documentation Issues: Insufficient or incorrect documentation provided.
- Misinterpretation of Policy Terms: Differing interpretations of policy language.
Understanding the reason behind the decision will guide your next steps.
2. Review Your Insurance Policy
Carefully read through your insurance policy. Pay attention to the coverage details, exclusions, and conditions. Compare the insurer’s reasons for denial or underpayment with the policy terms. Look for any discrepancies or misinterpretations.
3. Gather Supporting Evidence
Collect all relevant documents and evidence to support your claim. This may include:
- Incident Reports: Detailed accounts of the event that led to the claim.
- Photos and Videos: Visual evidence of damages or losses.
- Receipts and Invoices: Proof of expenses and repairs.
- Correspondence: Communication with the insurance company and any other relevant parties.
Having thorough documentation will strengthen your case.
4. Contact Your Insurance Agent or Broker
Reach out to your insurance agent or broker. They can provide valuable insights into the claims process and advocate on your behalf. Explain the situation and provide the necessary documentation to support your case.
5. File an Appeal
Most insurance companies have an appeals process for denied or underpaid claims. Follow the instructions provided by your insurer to file an appeal. Include a detailed letter explaining why you believe the decision was incorrect, supported by the evidence you have gathered. Be clear, concise, and professional in your communication.
6. Seek Legal Advice
If the appeal is unsuccessful or if you encounter significant resistance from the insurance company, consider seeking legal advice. An attorney specializing in insurance claims can provide expert guidance and represent your interests. They can help you understand your rights and explore legal options if necessary.
7. Consider Alternative Dispute Resolution
Mediation or arbitration can be effective ways to resolve disputes with insurance companies without going to court. These methods involve a neutral third party who helps facilitate a resolution. Check your policy to see if it includes a clause for alternative dispute resolution and discuss this option with your attorney.
8. File a Complaint with Regulatory Authorities
If you believe the insurance company is acting in bad faith, you can file a complaint with your state’s insurance regulatory authority. Provide them with all relevant documentation and details of your case. Regulatory authorities can investigate and take action against insurers who violate regulations.
9. Keep Detailed Records
Throughout the entire process, maintain detailed records of all communications, documents, and evidence related to your claim. Keep a log of phone calls, emails, and meetings. Organized records will be invaluable if you need to escalate the matter further.
10. Stay Persistent and Patient
Resolving a denied or underpaid claim can be a time-consuming process. Stay persistent and patient. Follow up regularly with your insurance company, agent, or attorney. Keep advocating for your business’s rights and interests.
READ MORE: 5 Signs It’s Time to Hire a Missouri Small Business Attorney
At Saxton Law Firm, our Missouri business insurance claim denial attorneys are here to help you. Contact Saxton Law Firm for a FREE case review!