No one likes to give away his money, especially not businesses. They try to save money from every possible corner they can find. Companies even have people whose only job is to look for a way to save money. They don’t care about what’s right or wrong. There is no such vocabulary in the dictionary of businesses. Their main priority is always to save or get money to maximize their profits. Worst of all, they do it in a legit way that there is hardly any loop to prove that it’s illegal.
When talking about businesses that don’t like pay, insurance companies are the first to pop up in our heads. Insurance companies don’t mind charging us high for premiums and taking monthly or yearly fees. But it’s like a surprise for them when someone asks them to pay back. This is the promise they make. They will help us at a time when we need the most. However, most companies become an addition to our existing problems when we need them to pay us back. A person going through difficult times and who is already tense and doesn’t have much energy to deal and fight for his right, they take full advantage of this fact.
Of course, they can’t simply ask you to go away. So they come up with excuses. If there is a possibility to deny your claim, they will put it up. If the denial is not possible, they will look for ways to lower the claim as much as possible. If you don’t do everything carefully and don’t understand their tricks, you will end up losing a lot of money.
You can always acquire the services of a bad faith lawyer to help you get your claim, but there is no guarantee that they will win the case. However, it is doesn’t mean there is no other way around. You should definitely get the help of a lawyer, but also prepare yourself for the tricks insurance company representatives might play on you. This will allow you to avoid all those mistakes and prepare a strong case to present in the court. Here I have shared the most popular excuses insurance companies use to lower or deny your claim.
Claim Wasn’t Filed Correctly
Mankind should make things easy for each other. We are developing new technologies and systems to make life easier. But most companies make the processes as difficult as possible when they are about to be held liable for something. They have so many complications and rules when it comes to filing a claim that the person is likely to make a mistake.
First, they make so many policies and rules to make them difficult. Second, they set conditions that you must fulfill before you may claim your right. On top of that, they have their own way of judging whether your story is true or not. So among all that, if you make a single mistake of not filing the claim correctly, they will reject your application, and all that subscriptions you paid would go to waste.
They are Not Liable for this Case
It’s not uncommon for insurance companies to say that they are not liable for this particular case. You might be under the impression that they provide cover in such a situation, whereas they might have tricked you with careful use of words. For example, if you had a car accident, they might not cover the expenses if it was your fault. Likewise, if you suffered some damage due to bad weather, they might say that it doesn’t fall under what they cover.
Usually, they win such cases. So, you have to carefully read all the terms and conditions to understand where you will get their help. It’s also possible for them to describe the case differently to make it not their responsibility. Make sure they didn’t make any such commitment verbally and wrote something different in your documents. If such was the case, you could get back at them with the help of law for fraud.
These Injuries are Not New
You must have heard that you shouldn’t delay going to the doctor and contacting your insurance company when you are injured. There is a good reason why people suggest it. If your injuries a little old, they will come up with an excuse to prove that you are filing the wrong claim. Thousands of people have heard this one, and they have to prove that they were actually hurt so the company should cover its medical expenses. Make sure you contact the company as soon as possible and also take proof of what happened to you.
Many people take photos of their injuries to show it to the representatives and to the court if needed. If they can somehow prove that these wounds are not from the time you say they are, they won’t have to pay you and possibly cancel your subscription with not returning any of your funds. Wounds won’t take time to heal once they are wrapped. If you have proper proof and you have contacted the insurance company on time, you won’t have to face this issue.
There is No Property Damage
If there is no damage to the vehicle or the house or on anything that you have insured, then how come you got injured when the other thing has suffered no damage. This is most common in the case when you are trying to claim insurance from a car accident. They have a team of investigators of their own to look into every matter in detail. The job of those investigators is to find a reason why they shouldn’t pay you.
You should never try to do anything yourself to make your case more powerful. Make sure you just follow what’s right. If you tried to increase the damage just to prove that the accident actually happened, then you are weakening your own case. Make sure you have prepared yourself mentally for all their questions, that’s all you need. If you are calm and at the right, there is nothing to worry about. Trying to take it up to yourself to provide enough proof could get you into trouble. Remember, it’s them who need to find proof whether you are wrong, not you.
There Shouldn’t Have Been a Gap in Treatment
Suppose you went to a doctor for some time. When you started to feel better, you stopped going so there is no wastage of time and resources. But, you need to go to the doctor again for the same issue because it didn’t heal completely. What you did was moral, trying to save money even if it was the company that had to pay for it. However, the representatives of the insurance company might see it differently. They can use that gap in the treatment as an excuse to prove the later visits were either for no reason or for another reason.
This could become their strong point, even in the court. That’s why it’s important to record your every visit in writing. Store all the prescriptions and slips to and doctor’s statements if needed. No one would have any way to deny your claim if you have every single in written proof. If possible, you should also avoid any such actions that you believe could create a doubt.
Treatment is Not Scientifically Proven
If you have been getting treatment, but it’s not the conventional type of treatment, this may be used by the other party to deny your claim. If you have been getting treatment in an experimental, new, or unnecessary method, it could weaken your application. Although there is nothing wrong with participating in new programs, the company might have a policy against it. They would only go with the safest and cheapest way for everything. So there is a possibility that a new method of treatment might cost them more than the conventional method even if it was more effective. You should read the policies before you sign it to ensure if they have any such limitations to avoid later problems.
Policy Limit has Exceeded
Although it’s very basic and it may not always be an unnecessary excuse, it’s something you need to watch out for. Know how much your policy covers before you make any claims. It wouldn’t come as a surprise if you had some misconceptions about your policy limit as everything looks like roses and sunshine before buying the insurance. It’s later that you realize how complicated everything is. You might be reading something else while it meant something else. Conjunctions can really create problems by adding new meanings to the sentence.
Provided Information was Misleading
Whatever information you provide, you need to have proof of it. If you told them something that wasn’t correct or not possible to prove, it would be considered as an attempt to mislead and fraud. It’s not that all insurance companies or their representatives are bad. It’s just that they also have to secure themselves. They have to deal with hundreds of clients, and not all of them understand the meaning of ethics.