Insurance Refusal
It is not uncommon for an insurance company to refuse to pay an insurance policy under certain circumstances. Refusing to pay a claim is an indication they feel they have determined that they should not have to cover the risk or that some clause of the insurance policy is inapplicable.
There are several different scenarios in which an insurance company may refuse to pay a claim. A policy holder may neglect to pay premiums due and the company may terminate the policy and refuse to cover any losses after the policy end date. An insurance company may also refuse to pay in the case of an act of fraud or misrepresentation by the policy holder when they purchased or after theyd purchased the insurance. This could include false or misleading information on a policy application, or missing information regarding any potential losses. Insurance companies may also refuse to pay claims where their policy does not cover the type of loss suffered, or any contractual relationship does not exist between the policyholder and the insurer.
Insurance companies may also refuse to pay when the policy holder engages in risky behaviors that are not covered under the policy. These could include things like driving without a valid license, sky diving or other extreme sports, failure to file a police report, failure to inform the insurer of a loss within a certain period, or destruction of evidence at the scene of a loss. Some policies might even cover events such as acts of God, but the insurer may refuse to pay if the policyholder did not take reasonable measures to protect their property or possession.
If an insurance company refuses to pay a claim the policyholder may take steps to dispute the decision. Most policies will have a clause regarding the policyholders right to dispute a determination or settlement. The policyholder may hire a lawyer and take the insurance company to court. They may also demand an official explanation detailing why the claim was refused. This could lead to reappraisal or reconsideration by the insurance company, or a settlement if the policy holder decides to compromise. The policyholder may even make a complaint to their states department of insurance, if they feel the insurance company has acted in bad faith.
An insurance refusal can be a stressful and costly situation for a policyholder. Its important for the policyholder to have a comprehensive understanding of the circumstances of their policy and the details of their insurance premiums or they may find that theyre not adequately covered in their time of need. This can easily be avoided by always reading the details of a policy before signing and keeping paperwork in a safe place. Most insurance companies are eager to resolve claims and disputes so that the policyholder can receive the compensation they are entitled to if a loss occurs.