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Insurance Claims

When you purchase insurance to protect yourself or your property – whether it be homeowners property insurance, car insurance, business insurance, life insurance, or any other insurance – you expect that when you submit a valid claim, the insurance company will process and handle the claim in good faith and pay the money they are responsible for paying to you, the policy holder.  All too often, that system breaks down when insurance companies deny valid claims, offer far less money than the claim is worth, or unnecessarily delay in paying on a claim.

Generally, the answer to this question involves a very elementary understanding of math.  Insurance companies make money when policy holders pay premiums.  By never having to pay out money on those policies, or by paying the least amount of money possible, insurance companies make larger profits off the policy.  Obviously, this is not the reason the insurance adjuster will give you when he or she denies your claim.  Instead, they generally will use one of the following reasons for denying your claim:

  1. The insurance policy does not cover the loss/damages/injuries you are claiming;
  2. There was a material misrepresentation in your application for insurance; and/or
  3. Premiums were not paid on time and coverage lapsed.

All of the above are valid reasons to deny a claim.  However, all too often, skilled insurance adjusters will deny the claim using one of these reasons – particularly the first one – when in fact the claim is valid and should be paid.

Another tactic we see far too often is insurance companies delaying payment for so long while they “investigate” a claim.  This is particularly common in large property damage claims involving storm damage or fire damage.  Insurance companies certainly have a right to conduct a reasonable investigation into a loss.  However, that investigation must be reasonable and should not go on for months and months on end without any conclusions.

If you have submitted a valid insurance claim for a loss that you were insured against, and the insurance company denied the claim for a reason that you are not convinced is valid, or, if the insurance company has not made prompt, fair payment to you for a loss, you should contact an experienced insurance claims lawyer.

At the Law Offices of Robert D. Rouse, III, attorney Robert Rouse has over 40 years of experience reviewing insurance policies and determining whether or not there is coverage for a particular loss.  Attorney Rouse has extensive experience litigating cases against insurance companies for unfairly, unlawfully, and in bad faith failing to properly pay claims and will take all action necessary in order to get your insurance company to pay those amounts that they are obligated to pay in accordance with North Carolina law.  North Carolina General Statutes 58-63-15(11) defines unfair settlement claims practices and such violation of those statutes is an unfair and deceptive trade practice.  Our insurance claim lawyer has successfully argued for awards of treble damages in addition to other damages in North Carolina for violations of North Carolina law which amounted to unfair settlement claims practices.

It cost you nothing to see if we can help with your insurance claim or insurance denial.  Contact our Pitt County law office or Carteret County law office today to set up a free, no obligation consultation.

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