San Antonio TX Insurance Claims Lawyer

When advertised on TV, insurance companies make claims that you are in good hands. Some compare themselves to a good neighbor. But insurance companies have, as their main focus, the duty to produce a profit. In other words, they owe a stronger duty to their shareholders than they do to their policyholders.

Nonetheless, they are expected to always act in the best interests of their policyholders. If they have denied a claim and they don’t have a legal reason to do so, they can be held accountable under bad faith denial laws.

Brylak Law litigates claims against insurance companies when then wrongfully deny injury claims or deny claims in bad faith. If you are having trouble getting your own insurance company to pay out or are filing a claim against another party’s insurance company and they refuse to pay up, a San Antonio TX insurance claims lawyer can help.

Filing a Claim Against an At-Fault Party’s Insurance Policy

People file claims against another’s insurance policy frequently. In fact, one of the main reasons to carry auto or homeowner’s insurance is to protect yourself from liability. However, the process doesn’t always go as smoothly as it should. Insurance companies can find a number of reasons to deny your claim and if there are any ambiguities in your claim file or you’re missing information, they will interpret these gaps against you. On your end, you will need to provide them with medical reports, incident reports, and be able to prove damages.

An Insurance Company Has a Fiduciary Duty to Their Policyholder

When you’re filing a claim against another party’s policy, the insurance company has a fiduciary duty to protect them from liability. This pits you on opposite sides of the battle. The insurance company protects itself and its client from litigation while you and your personal injury lawyer ensure that your case is airtight.

When you’re filing a claim against your own policy, it’s a bit different. In this case, your insurance company has a fiduciary duty to you but only up to the terms of the policy limit. If they can find a reason to deny your claim, they will. This applies equally to personal injury protection, long-term disability claims, life insurance policies, and uninsured/underinsured auto insurance policies.

Why Are Liability Insurance Claims Denied?

Liability insurance is insurance purchased for the purpose of protecting the policyholder from liability. In other words, if someone is injured due to carelessness or negligence, a liability insurance policy will cover the damages up to the policy limit. These include claims like medical malpractice, auto insurance, homeowner’s insurance, and a business’s general liability coverage.

• Dispute over liability. These claims are generally denied outright only when there is a dispute over the accident. For instance, when the policyholder claims that the injured party is responsible for the accident. In personal injury cases, Texas law stipulates that an injured party can be no more than 50% responsible for the accident. In other words, any claimant who is 51% responsible for their injuries (or more) can have their claim denied outright. For that reason, the insurance company has an incentive to blame you for the accident.
• Dispute over injuries. The insurance company may claim that your injuries were not a direct result of their policyholder’s negligence. In this case, you will need to prove that they are. In some cases, they muddy the water by claiming that their client’s negligence only made a pre-existing condition worse.
• Policy issues. Sometimes, the policyholder may have violated some term of the policy or was delinquent in their payments. In this case, the policyholder is personally liable. In other words, they will have to pay out of pocket for your damages. As an example, a homeowner’s insurance policy may not cover certain breeds of dogs in dog bite cases. In addition, if the policyholder misrepresented their dog to the insurance company or failed to report a certain breed of dog to their insurance carrier, then the insurance company may be able to claim that there was a policy violation.

Duty to Act in Good Faith

When you’re making a claim against an insurance policy that you pay for, the insurance company has a fiduciary duty to act in your best interests. This is called operating in good faith. If an insurance company denies your claim without good reason, they have violated their duty to act in good faith.

Contact a San Antonio TX Insurance Claims Lawyer

Most claims are denied because the insurance company does not have sufficient evidence to leverage them into making a payment. Your attorney’s job is to ensure the insurance company does their job and either satisfies the terms of a contract that you signed or covers their client in the case of negligence. Brylak Law helps those who battling insurance companies for money they deserve. Contact us to begin discussing your options today.

Why Were My Life or Disability Insurance Benefits Denied?

After contributing so much money to your insurance, the last thing you want to deal with is having your life or disability insurance benefits denied. However, a denied claim is not necessarily the final verdict. When the denial is in bad faith, you may legally contest the denial to receive the funds owed to you.

Life Insurance Benefit Denials

If you have been denied life insurance benefits as the beneficiary, you are entitled to appeal the denial. Although there may be situations where the denial is valid, often the denial is due to a mistake or made in bad faith. Our insurance claims lawyer in San Antonio frequently sees bad faith denials occurring during these situations:

• Death occurred during a contestability period, which is generally the first two years of the life insurance coverage or reinstatement.
• Alleged material misrepresentation, such as a mistake, error, or omission the policyholder may have made in the initial application for life insurance coverage. If, however, during the application process, the insurance agent led the policyholder to complete his or her application erroneously, whether by accident or intentional, you may be able to recover the benefits owed to you.
• Death during the application period, which is when the policy application is being completed and finalized, if the insurance company offered temporary life insurance during this period.
• Denial of accidental death benefits, although the company may pay for the policy’s face value.
• Claim denied due to lapse in payment.
• Settling an incontestable policy for a reduced amount of the benefits.

Disability Insurance Benefit Denials

When your disability insurance benefits are denied, the reason is often one of the following:

• Your illness or injury is not severe as to impair your ability to work.
• There is no objective medical proof of disability
• You actually suffer from mental illnesses (e.g. depression, anxiety or stress) rather than physical limitations or restrictions

Speak to a San Antonio TX Insurance Claims Lawyer

Appealing or suing for denied insurance benefits is complex and often times both contract and fact-oriented. Our attorney will meticulously review your policy, investigate your claim, and develop the best strategy to obtain the benefits you are rightly due.  Call us today to discuss your benefits denial with our San Antonio insurance claims attorney at Brylak Law.