5 Signs Your Insurance Provider Is Wrongfully Denying Your Benefits and What To Do

When you file an insurance claim, you expect a smooth process and a prompt, fair payout. Unfortunately, this is rarely the case for many policyholders. Many insurance companies prioritize profits over the insured, using every dirty trick in their playbook to minimize or entirely deny payouts. While insurers are legally required to act in good faith, bad faith practices are often witnessed when making a claim. If you suspect that you have been wrongfully denied benefits, you can challenge that decision. Below, we discuss five warning signs that your insurer is wrongfully denying your benefits and what you can do.

1. The Insurer Claims Your Policy Doesn’t Cover the Incident

One of the most frustrating tactics insurers use is claiming that your policy doesn’t cover your specific situations. Some insurers even go as far as altering your policy terms after a claim is filed to avoid paying out. If an insurer suddenly interprets your policy differently than they did when you signed it, it’s a red flag. Review your policy carefully and seek legal advice to confirm whether the denial is justified.

2. The Investigation Feels Inadequate or Suspicious

Insurance companies must conduct fair and thorough investigations when processing a claim. If your insurer had questionable tactics, like working with unqualified individuals purporting to be “experts,” they’re probably playing you. A legitimate investigation should be transparent and efficient.

3. Major Delays in Processing Your Claim

Delays are one of the most common strategies insurance companies use to pressure policyholders into giving up or accepting low settlements. If the insurer is dragging out the process unnecessarily, and you’re stuck without any updates for months, it may be a bad faith tactic, intentionally slowing things down to avoid paying the benefits you deserve.

4. Poor Communication

If your insurer is suddenly difficult to reach, ignores your calls, or provides vague, evasive responses, they may be acting in bad faith. A legitimate company should update you about your claim’s progress and provide clear reasons for any delays or decisions. If getting answers from the insurance company has become challenging, consider seeking legal help.

5. Lowball Settlement Offers or Pressure Tactics

Another common trick is offering settlements far below what your claim is worth. Some insurers do this hoping that policyholders, especially those facing financial strain, will accept the unfair settlement out of desperation. Others might even employ intimidation tactics, warning that rejecting the offer will only lead to long battles without any guarantee of success.

What To Do if Your Insurance Claim Is Denied

If your claim has been wrongfully denied, consider taking the following steps:

1. Document all records relevant to your claim, including communications with the insurer and medical reports, in case you need to challenge the denial.
2. Request a written explanation of the denial. This will force them to outline their justification and help you identify any inconsistencies or misinterpretations of your policy.
3. Review your policy and follow the necessary steps to challenge the denial.
4. Consult an attorney who can analyze your policy, identify any violations, and negotiate a fair settlement. If necessary, your attorney may also file a lawsuit to hold the insurer accountable.

Our Knoxville Civil Litigation Attorney Can Help

If your insurance provider is wrongfully denying your benefits, you don’t have to face the battle alone. Contact our Knoxville civil litigation attorney at Reynolds, Atkins, Brezina & Stewart, PLLC, today to fight for the compensation you deserve.