Denied Insurance Claims
You paid your premiums. You filed your claim. And the insurance company said "no." When that denial lacks reasonable basis or proper investigation, it's not just frustrating—it's bad faith.
Key Takeaways
- Denials require reasonable basis: Insurers can't deny without investigation
- Policy language matters: Denial must match actual exclusions and terms
- Don't accept denial as final: You have appeal rights and legal remedies
- Bad faith opens additional damages: Punitive damages, emotional distress recoverable
Types of Wrongful Claim Denials
Insurance companies deny claims for many reasons—not all of them legitimate:
Denial Without Investigation
The insurer rejects your claim immediately, without reviewing documentation, interviewing witnesses, or engaging experts.
Misapplied Exclusions
They cite a policy exclusion that doesn't actually apply to your situation, or interpret clear language in ways it was never meant to be read.
Pretextual Reasons
The stated reason isn't the real reason. They claim 'insufficient documentation' when they have everything, or 'pre-existing damage' without evidence.
Ignoring Favorable Evidence
They cherry-pick evidence supporting denial while ignoring evidence supporting coverage—photos, expert reports, medical records.
When Denial Becomes Bad Faith
Not every denial is bad faith—but these patterns cross the line:
No Reasonable Basis
The denial can't be supported by the policy language or the facts. No honest evaluation of the claim could reach that conclusion.
Failure to Investigate
The insurer denied without adequate investigation—didn't review all documentation, didn't hire appropriate experts, didn't speak to witnesses.
Ignoring Claim History
Similar claims were approved in the past, but yours was denied without explanation for the different treatment.
Moving Goalposts
First they cite one reason for denial; when you address it, they find another. The real reason is they don't want to pay.
Denial Despite Internal Recommendations
Internal adjusters or experts recommended covering the claim, but management overruled them to avoid payment.
Pattern of Denials
The insurer systematically denies this type of claim as a business practice, regardless of individual merit. We subpoena their claims data to prove patterns.
What to Do After a Denial
A denial letter isn't the end. Here's how to respond:
Get the Denial in Writing
If they denied verbally, demand a written explanation. The letter should cite specific policy provisions and factual basis for denial. Vague letters are evidence of bad faith.
Review Your Policy
Read the coverage provisions and exclusions yourself. Does the denial actually match the policy language? Many denials misinterpret or misapply policy terms.
Gather Your Evidence
Compile everything supporting your claim: photos, receipts, medical records, expert opinions, witness statements. The stronger your documentation, the harder denial becomes to defend.
File a Written Appeal
Most policies allow internal appeals. Submit your evidence and explain why the denial was wrong. This creates a record and may reverse the decision.
Consult a Bad Faith Attorney
An attorney can evaluate whether the denial constitutes bad faith, obtain the insurer's claim file through litigation, and pursue the full range of damages—not just denied benefits.
Frequently Asked Questions
Fight Your Wrongful Denial.
If your insurance company denied a valid claim without reasonable basis or proper investigation, you have rights. We hold insurers accountable.
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