Common reasons insurance claims are denied & what to do
It may be a shock to you when the insurance claim that you were expecting to be paid has been denied. No matter the type of insurance claim, you always have recourse, and an Orange County insurance lawyer at Quincey Law can help you deal with the situation.
Insurance companies can be very aggressive about denying claims and forcing you to fight. They may think that you will go away if they deny your initial claim. Not only can you sue the insurance company to force them to pay the claim, but you may also seek compensation for the damages they caused you if their conduct was egregious enough.
Reach out to Quincey Law to learn your options when your insurance claim has been denied. The law can be complex, but we will patiently explain to you what you may be able to do in response.
The insurance company will often use a hypertechnical reading of your coverage to try to deny your claim. They may give you very terse reasons for the claim denial, forcing you to fight before you learn more of their thinking. In the meantime, here are some of the reasons that insurance companies give when they deny your claims.
The Claim Is Not Covered By Your Policy
The insurance company can be extremely technical when it comes to interpreting what is covered by your policy. They may claim that your claim falls within the long list of exclusions that are contained in the fine print. The insurance company has been known to misrepresent the actual language of the policy in an attempt to deny claims, even though that would be considered bad faith. Insurance companies can be very aggressive about denying claims entirely.
There Is Insufficient Documentation for Your Claim
The insurance company rarely, if ever, gives policyholders the benefit of the doubt when they are processing claims. They insist on seeing your claim extensively documented, both the reason for it and the paperwork that proves your claim. They will not hesitate to deny a claim if the requirements of the policy are not followed to the letter. They can get very technical. The good news is that these claims may be eventually resolved, but they can cause serious delays when it comes to getting your payment. It may be a good idea to hire a lawyer to help with your claim if there are very high stakes involved.
The Insurance Company Accuses You of Misrepresentation
There are some types of policies, such as life insurance, that require you to make representations upfront when you purchase the coverage. Other policies may seek representations when you make the claim. The insurance company may claim that you failed to fully disclose the necessary information, either because you did not share it with them, or you made an affirmative misrepresentation.
Your Coverage Has Lapsed
This is perhaps the most common reason insurance companies deny claims. They argue that you did not keep up the premium payments, so the policy was not in effect when the event that required coverage occurred. For many types of policies, insurance companies actually need to give you prior notice that your coverage is going to lapse due to non-payment of premiums.
You Have the Ability to File a Lawsuit
In the end, you always have the right to take some type of legal action against the insurance company. Your recourse may come from state or federal law, but you can almost always file some type of lawsuit to force the insurance company to pay you the benefits that they owe you under the terms of the policy. You may even be able to sue the insurance company directly in a bad faith lawsuit if their conduct crosses the line from poor business practices to illegal conduct.
You should contact an attorney if you believe that the insurance company has wrongfully denied your claim. A lawyer would not charge you for the free initial consultation. They will review your case and explain whether you may file a lawsuit against the insurance company for their conduct. The insurance company is not a judge or jury, and they do not get the final say, nor can they do whatever they want.
Contact an Orange County Insurance Claim Denial Lawyer Today
Get in touch with Quincey Law when the insurance company is trying to take advantage of its power to push you around. Call us today at 866-945-9175 to schedule a free initial consultation to discuss your case. You do not need to pay us anything unless you win your case.

Nicholas Quincey is the founder of Quincey Law, and has over a decade of experience of handling insurance claims denials and personal injury matters for people throughout California. We have pursued insurance bad faith claims for people involving life insurance, health insurance, homeowners and disability insurance. We also work with clients and families who need assistance filing and pursuing a personal injury matter. Learn more here.