Did you know your insurance company can decide not to pay your claim?

Question

You pay for insurance today but never see what was promised until the day there is a claim. You trust the insurance company. But what if it decides to pay less than the claim, or none of the claim? Does it refund your premiums paid, or return half your premiums if it pays only half the repairs on your car? Insurance operates totally opposite to normal business - it is based on laws that require both parties to act with integrity and honesty, and the insurance company is required to find a reason to pay your benefit, not deny it. The reality is, most companies try to take your money and find ways not to give it back.

Answer 1

was it denied because

the claim below the deductible

was it a cover cause of loss(check your policy)

insurance does not pay for wear and tear - it actually will deducts from the claim it values as wear and tear

example my 2000 Ford died it was valued at $6,000
with 140,000 after deductions for milage and wear and tear (even the condition of the carpet) I got $3,500 - still owed $2000 on the loan (thank god for GAP) -- They took my all premium - I got less than half a claim but the claim was paid correctly

I know not what you wanted to hear

Answer 2

Insurance companies operate within contract laws. They are the same laws that I follow, you follow and the insurance companies follow. The insurance companies cannot arbitrarily decide they are not going to pay a claim for no reason. They have to base their reason on what is written in the contract, or else they can be sued and not only will they have to pay for the actual damages, but they are opening themselves up for punitive damages as well.
When you buy an insurance policy you are entering into a contract. It is the responsibility of each party entering into the contract to understand what it is they are agreeing to before they enter into the contract. If one party did not bother to read the contract and understand it, then they cannot turn around and blame the other party for following the contract because they were to lazy to perform due diligence.

Answer 3

Are you done yet? This is something that has been said a million times already. Yes insurance companies can deny claims. It is all based on the policy you purchased. I trust no one. I read everything I buy and spend my hard earned money on. It is your stupidity that leads you to trust and not get what you see as "promised".

You don't have to buy the insurance, it is your choice! Pay cash for your house, don't drive on public streets, pay your medical bills out of pocket. Insurance is not mandated.


RKO and Condor you just sound bitter.

Policies are very clear. If you are not smart enough to read them and see what is covered then you need to have someone help you.

Answer 4

They dont just randomly say, "ok today we are only paying ever 5th claim that comes in today"

The insurance company is required to pay as agreed in the contract. If for example, your contract for car insurance dictates that you are to be the only driver allowed to drive that car, and your brother from out of town goes for a ride (with or without your permission), & crashes into someone. If they told you ahead of time that they will not pay for that, should they?

With life insurance you are told that suicide is not covered within the 1st 2 years of a contract. If that person pays $50 for a million dollar policy & jumps off a roof 2 weeks later, is that a good claim?

If false info is given on an application, & insurance is given based on the false info, & it is discovered later, should it still be paid out accordingly? The obvious answer to all of these is no. So long as you abide by your side, they will abide by thiers. Granted, I know that there may be a handfull of less than honest agents that may stretch the coverage truth, but they cant override what is in black & white on your contracts.

Sounds to me that you just had a bad experience of being denied for something that you assumed was covered but was not. Give some detailed info on that so we can help a bit more.

****edit****
boy, some of you are pretty upset about stuff that has nothing to do with the question (which by the way there was no question). RKO- you have full control of how much you are charged for a mortgage! Pay cash for your house, make extra payments, dont finance for 30 yrs.

If a MD goes up 10% on his fees, the insurance co. goes up 25%, how is that the MDs fault? They get paid pennies on the dollar from your health company, & you get mad at them for needing to pay the staff?
Last I checked I dont get charged usery by a "pharma". I pay the pharmacy my co-pay. Usery is what you get charged in excesive interest. You dont finance Tylenol through Johnson & Johnson. Lawyers charge fees based on expertise. If it is so simple to file a suit or defend one, go to Staples & get the fill in the blank form & hand it to the judge. I am sure that is what Jonny Cochran & Matlock did. Its not Mad Libs from 5th grade!

Condor- you are right, they should not look to see if anyone lied on the form & are trying to make off with everyone elses money! They should just hand it over with no questions. Its a contract, read it & understand what you can & cant do in it. Let me call my insurance co. & claim a $50 paint chip & get the full $50k in damages per accident I am entitled to! Sure & let me get $1 million on my nieghbor & then I get rid of him & collect, no questions. Your world sound utopian!

Answer 5

Actually, there are some perfectly legitimate reasons why an insurance company may deny a claim. For instance, when policyholders are committing insurance fraud by failing to disclose (or even specifically excluding) high-risk drivers who have regular access to vehicles, or failing to acknowledge that they may be running a business out of their homes.

Yes, both parties are supposed to act with integrity and honesty. That ALSO means the policyholders.

True, there are some fly-by-night insurance companies who will deny, deny, deny... then again, you often get what you pay for in such matters.

If you have a specific greivance, then talk to the commissioner of insurance in your state. Make an official complaint. If companies are denying LEGITIMATE claims, then they deserve to be run out of business.

But generalized b*tching doesn't really help your case.

Answer 6

You are absolutely correct. And this just do not apply to Automobile Insurance, but to Homeowners and Medical Insurance as well. First thing after you present them a claim most insurance companies will look in to your original application for insurance in order to find some discrepancies, omissions and misrepresentation on your part so that they will have a reason to deny or to reduce an amount of your claim. Then they will check you thru certain indexing systems to see if you had similar claims before in order to have another reason not to pay your claim. Even if you are being represented by an attorney insurance company will find a ways to deny your claim or to reduce an amount of payment which is rightfully due to you. Sometimes when you and/or your attorney too aggressively pursue your claim and should you file a lawsuit against them, insurance company in most cases will file a counterclaim against you. They may also allege a fraud in their counterclaim in order for you to drop your litigation against them. Insurance companies are nothing but plain thieves and robbers. Insurance polices which they issue does not Worth a paper on which they a re printed. The worst insurance companies for automobile insurance claims are: 1. Allstate, 2. State Farm, 3. AIG 4. Progressive, 5. Hartford and their subsidiary substandard company Omni Insurance. The worst companies for homeowners claims are: 1. Allstate, 2, State Farm, 3. AIG. The worst insurance company for medical trip insurance is: Lloyds of London/Petersen International Underwriters. Decent companies are: Amica Insurance, Erie Insurance Company/Exchange and some other small companies. The bigger your insurance company the worth it is. Always get your insurance from small companies as they are way better pay claims.

Answer 7

Underwriters are was certain (IF), they want to insure you. once you observe for coverage, the underwriter makes a decision once you're a sturdy or undesirable probability and finding on the climate, will the two settle for or deny you a coverage. declare adjusters comments claims, AFTER, you have gotten a coverage with the coverage company and then determines, what's roofed, if there a deductible, or co-coverage, and could pay in keeping with your coverage. sturdy success

Answer 8

Insurance is just one of the most shameful scams inflicted on most American citizens.
* You can pay your premiums faithfully for years - yet when it comes time to legitimately collect, your insurance company will find ways to deny your claim;
* We've been conditioned to believe that a mortgage company or bank must charge you three-to-four times the purchase price of your home over the term of a 20 or 30-year mortgage. So you pay hundreds of thousands of dollars more in interest than you ever do in principle - and business schools teach that as fair, moral and legitimate ways of doing business;
* Hospitals and doctors routinely charge tens of thousands of dollars for 'services' just because they know they can get away with it;
* We pay more for medicine in this country because 'Big Pharma' has bought off all the politicians that allow such usury;
* Lawyers demand two-hundred-dollar an hour fees for filling in the blanks on routine documents only because they know their clients are at their mercy;
* Taxes are imposed by governments because most citizens are afraid to stand up and say, 'I refuse to pay!';
As George Bernard Shaw once said: "Democracy is a form of government that substitutes election by the incompetent many for appointment by the corrupt few."
-RKO- 08/28/07

Answer 9

That's why you can contact your Better Business Bureau or the Attorney General.