Delayed claim

The insurance industry is bound by law to act in good faith with its customers. There are many instances, however, when insurance companies employ unfair tactics and avoid paying claims promptly, financially benefitting from the delays. In other words, claims have been converted into a money-making process.

Insurance claim delay tactics are the most common obstacles used by insurance companies to avoid payment of claims. In many instances a claim delay may be due to legitimate reasons, especially in a case of a contestable claim. Often, however, life insurance companies delay paying claims as a tactic to force the beneficiary to wait for settlement of the claim, with a hope that the beneficiary will eventually give up.

Not every beneficiary has sufficient knowledge to identify the difference between legitimate insurance claim investigations and illegitimate claim delays. An insurance company has a duty to conduct insurance claim investigations. The main point here is that the investigation must be reasonable and timely. Insurance policies require that the insured must cooperate with the insurer in the claim investigation process. These conditions are stated in the life insurance policy. Accordingly, it is reasonable for your insurer to ask you for specific documents or items related to your claim.

If you comply with requests for relevant information and documents, you may expedite the review process. If you cooperate with the request for a recorded statement and proof of loss documents or affidavits, you will improve your chances of expediting the claim investigation process. Failure to comply with reasonable requests, however, may result in a lengthy investigation and a probable claim denial.

Many of our clients call us for help after they have fully cooperated and the insurance claim remained unreasonably delayed. If that is the case, you should speak with our life insurance attorney who will investigate the delay for you and give you competent legal advice. At Kadetskaya Law Firm, we have expedited review of delayed life insurance claims caused by the following:

  • Confirmation of coverage: The insurer claims it is in the process of confirming coverage based on the terms of the insurance policy. Faulty policy interpretation is one of the more common examples of unfair tactics insurance companies will use to delay claims. This process frequently results in the eventual claim denial.
  • Ongoing investigation. The insurer has the duty to properly investigate the claim and keep you informed of the status of your life insurance claim. However, if to all your requests for a status update the insurance adjuster responds, “It is being investigated,” the claim is being wrongfully delayed. If there are no specific reasons for an unusually lengthy review, consult with a life insurance attorney about your options.
  • Referral to the Special Investigations Unit (SIU). SIU referrals are legitimately a means to investigate potential insurance fraud. If there is no evidence of fraud, however, SIU referrals represent a process designed to avoid payment of insurance claims.
  • Examination Under Oath (EUO). The EUO is a formal proceeding taken under oath in front of a court reporter. An EUO is conducted when the insurer requires additional detailed information from the policyholder in order to make a coverage decision. EUO’s can also be used in wrongful claim delay, as an excuse to delay and eventually deny a claim. If you have been asked to attend an EUO, contact our life insurance attorney for a free consultation.

No Legal Fees Unless We Win Your Case!

Our attorneys work on a contingent fee basis. It means that we do not charge legal fees unless we collect the life insurance proceeds for you. Only then will we charge a reasonable legal fee. We take pride in offering competitive contingent fee structures and will work with you to ensure you are comfortable with the fee.  If your claim has been denied or delayed, call our life insurance lawyers for help. We have the experience you can trust.

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