An insurance claim is a formal request made by a policyholder to an insurance company seeking compensation for a covered loss or other event covered within the policy. The insurer will either approve or deny the claim. If approved, it will issue a payment to the insured or a sanctioned party on behalf of the insured.
As such, there are many various situations in which you have the ability to make a claim, depending on the circumstances involved.
Health Insurance: A claim is made for payment whenever you receive healthcare or have a prescription filled that is covered under your health insurance policy.
Homeowner’s Insurance: Claims made under this type of policy generally occur if your home is burglarized or vandalized or an individual is injured on your property. This type of coverage is also applicable if your property experiences damage or loss due to lightning strikes, fire, hail, wind damage, and other specific natural disasters such as a tornado or hurricane. It should be understood that, as a rule, homeowner’s insurance does not usually cover floods, earthquakes, or sewer backups.
Auto Insurance: You would file an auto insurance claim if you were involved in an accident, your vehicle is stolen or damaged by a natural disaster, or you injure another individual or cause damage to their property with your vehicle.
Life Insurance: This type of claim is filed when an individual dies, and the beneficiary seeks to receive the proceeds of the life insurance policy.
Business Insurance: This type of coverage is taken out by business owners and provides coverage against such instances as slip and fall accidents and product liability claims.
How Does the Claims Process Work?
There are many varying factors that may affect how your claims process proceeds. You may be required to call your insurance agent, mail documents, or take advantage of new tech features that are available online or through the provider’s smartphone app.
One extremely critical aspect of the claims process is what is known as the deductible. This is the amount that you, as the policyholder, are required to pay before your provider pays out on a claim. You are responsible for paying your deductible, and then your insurer pays the remainder of the loss.
Health insurance is different in that it more often than not takes place without you, the insured, having to be involved.
What Should I Do if My Claim is Denied?
If your claim is denied, the first thing that you need to do is speak to a qualified attorney who can advise you of your legal rights and the options that you may have. It is important to act as soon as you are made aware that your claim has not been approved.
The attorneys at our law firm have a vast amount of skill and experience in dealing with insurance claim denials. Contact our law offices by calling 855-786-7674 and scheduling a free initial case review. We can examine your claim and make a determination as to how to best proceed with your case.
What Should I Hire an Attorney in McAllen, TX to Help Me With My Insurance Claim?
Our attorneys understand the various loopholes and other tactics that insurance providers often use to deny or delay paying your claim. The members of our legal team are also a part of the community and as such, care about your well-being. We are not afraid to stand up to the insurance companies on your behalf and fight to recover what they may owe you.
Contact our firm by calling 855-786-7674 and ask to schedule a meeting with a member of our legal team. We are located here in McAllen and ready to serve you.