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Personal Injury Insurance FAQs

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Insurance


What can I do when an insurance company refuses to pay a claim?

In some instances an insurance company will refuse to pay a claim submitted by its policyholder. This is often referred to as "denying" the claim. The claim may be denied, for example, because the company has determined that the loss is not a type that is "covered" by the terms of the insurance policy or that the person who suffered the loss is not an "insured" for purposes of the policy or that a policyholder engaged in some type of misconduct which "voided" the coverage. Because of the complexity of insurance policies and because the resolution of coverage disputes often depends on careful analysis of the unique facts and circumstances of each case in light of applicable state law, the assistance of an attorney experienced in the handling of insurance coverage matters is strongly advised.

Are there any options for resolving a dispute with my insurance company other than suing the company in court?

Some insurance policies contain a provision allowing or requiring arbitration of certain disputes between the insurance company and the insured, and this may include disputes regarding certain types of claims. "Arbitration" is a procedure for resolving disputes by use of neutral, private individuals ("arbitrators") as an alternative to a lawsuit, and it often is a cheaper and faster method of resolving contract disputes as compared with a court proceeding. This procedure usually is not available unless specifically stated in the policy or unless the insurance company and policyholder mutually agree to submit their dispute to arbitration. See also our section on arbitration.