If you recently submitted a claim and your insurance company denied payment, it may seem personal to you. However, this is what many insurance companies do to protect their own bottom line. You can be sure they will act quickly if you miss a payment, but you may not get the same speedy response when you need help.
You can always appeal if your insurance company denies your claim. However, rather than an outright denial, some companies simply take their sweet time investigating your case, requesting further documentation and frustrating you with the run-around. When dealing with South Dakota insurance companies, it is important to know your rights and your options.
Good faith, bad faith
Insurance carriers act in good faith when they do what they promise to do. If you have paid for coverage under certain conditions, good faith says the insurance company keeps its end of the deal and provides that coverage when you need it. An insurance company acts in bad faith if it does any of the following:
- Offers payment lower than your claim is worth
- Denies your claim unfairly
- Fails to investigate your claim thoroughly
- Intentionally confuses you with a complicated claims process
- Misleads you with ambiguous language in your policy
When your insurance company denies a claim, you may request a written explanation of the reasons for the denial. In case you find it necessary to take your complaint higher in the company (or even to the courtroom), it will be helpful to keep a record of any time you speak with a representative about your claim, noting the date, time and person to whom you speak. This log can be part of the records you keep of all correspondences between you and the carrier.
Mistakes or misbehavior?
It is possible that the denial of your claim was a mistake by the insurance company. It is also possible that the mistake was yours. Perhaps you forgot a payment, or you didn't pay for coverage of the damages you are claiming. Maybe you thought you were paying for coverage, but the language in your policy confused you. However, it is also possible that your claim is among the thousands insurance companies wrongly deny each year.
The purpose of insurance is to provide assistance and security during difficult times. You have every right to expect your insurance carrier to act in good faith by providing the coverage you deserve in a timely manner.