Tag: claim denial

What to Do If Insurance Refuses Your Car Accident Claim

A car accident is a traumatizing time, especially if you suffered injury or property damage. Add in an insurance claim denial and you may feel overwhelmed. Rest assured, there are some additional steps you can take to ensure you have what you need to get back on your feet.

Texas Is an At-Fault State

First, it’s important to understand that Texas is an at-fault state. This means that the insurance company of whoever is at-fault is responsible for the damages. Many reasons behind your denial stem from the at-fault rules in our state.

For example, if you’re more than 50% at-fault for the car accident, the insurance company isn’t responsible for your damages. Your insurance claim may also be denied if the at-fault driver’s policy lapsed prior to the accident. This is often due to the driver failing to pay his or her premiums.

Other reasons for insurance denials may be pre-existing conditions you have or if you delay receiving medical treatment.

972-450-1418– Has the at-fault driver’s insurance company denied your car accident claim? There are steps you can take. To learn more, visit us today.

What Can You Do If You Receive an Unfair Insurance Denial?

Insurance companies will do what they can to reduce their liability. Unfortunately, this leads to plenty of unfair denials. For example, an insurance company may exaggerate your amount of fault over the 50% line. If you receive a denial you believe is unfair, we recommend hiring an attorney who can help.

Filing an Appeal

An attorney can start by helping you file an appeal against the denial. Most insurance companies provide a formal appeal process you must follow to negotiate a settlement. An attorney will help you collect the required information, health documents and more to solidify your case.

Filing a Lawsuit

If your attorney can prove you’re not at-fault for your accident or if the insurance acted in bad faith, it may make sense to file a lawsuit against the insurance company. Yet, every case is different. It’s important to speak to an attorney who can help you make the right decision for your accident case.

Call a Professional Personal Injury Attorney Today

If your valid car accident claim has been denied, you have options. Allow the team at Fell Law Firm to help. Give us a call at 972-450-1418
or send us a message today.

October 4, 2020
2 Quick Tips for Dealing With Your Insurance Company

The essence of a contract is the promise. There’s more to contracts than that, of course, but for purposes of this blog post, the concept of making a promise cuts to the heart of bad faith insurance. Take denied claims, for example. You made payments on your insurance contract (as you promised, with your hard-earned money), with the expectation that if something bad happens—like serious storm damage to your home—you’d be covered. So the worst happens and you make a claim.

Now, the insurance company goes back on its promise by undervaluing the damage or denying your claim altogether.

What do you do?

Fighting with your insurance company because of bad faith? Call The Fell Law Firm in Texas at 972-450-1418 today for legal advice.

Quick Tip No. 1: Remember That It’s a Negotiation

The first thing to consider is that virtually no insurance policy is cut and dried. These contracts involve tricky, serious and sometimes life-changing events: tornadoes, fires, car accidents, etc. So there is nearly always some “wiggle room” in the contract that might allow an insurance adjuster to offer less than you expected—or nothing at all. Insurance companies are for-profit businesses and want to protect their bottom line, despite what their TV commercials say.

But this doesn’t mean you’re out of luck.

After you’ve made your claim, the adjuster might hope that you just take their offer (even an unfair offer) and go away. That’s what a lot of people do. It’s the classic case of a big organization—the insurance company with adjusters and lawyers—taking advantage of its power over the consumer. And it’s not fair.

But when you get an offer, think of it as a negotiation. It’s not the end, but the beginning. And it might be time to get a lawyer involved, if not right after the storm or accident.

Quick Tip No. 2: Examine the Language in the Policy

It might surprise you how often the language isn’t as cut-and-dried as the insurance company would pretend to believe. The same “wiggle room” that can work to the insurance company’s advantage can also work for you, depending on the circumstances of your case and the language in the policy.

Vague or unclear language can be decided in court or negotiated at the conference table. (Pretrial settlement is a common way cases are resolved.) There may be questions as to how a relevant clause is interpreted, for example, be it in your favor or in favor of the insurance company.

Call The Fell Law Firm for Advice

Remember, insurance companies write these contracts. They have their own lawyers, who don’t write contracts in a way that protects your interests, but their own.

Insurers create their contracts with a mind toward looking out for what’s best for their company, not necessarily what’s best for you. You need an experienced attorney who will advocate your side of the case, especially when you’re facing bad faith on the part of your insurance company.

If your insurance claim was denied, or you received an unfair offer from the adjuster, contact The Fell Law Firm via email or call us at 972-450-1418 for a free consultation. We will help you evaluate your situation and determine the next steps.

January 13, 2020
Commercial Insurance and Water Damage: Is My Business Covered?
A study performed by The Hartford, one of the country’s largest insurance companies, showed the most common and most costly types of insurance claims affecting businesses. Water damage ranked number two on that list, outranked only by burglary and theft. Water damage also came in as the eighth most expensive claim, at an average cost of $17,000.
For business owners, water damage can be particularly difficult because most commercial property insurance policies have exclusions for certain types of water damage, leaving the company potentially exposed to the full cost of clean-up and repairs. Here at The Fell Law Firm, we have clients coming to our Dallas area offices regularly because their insurance companies denied their water damage claims.

Does My Commercial Insurance Policy Cover Water Damage?

When a business suffers water damage, the owner wants to know whether the insurance policy covers it. The unfortunate answer, like so many answers in the insurance world, is “it depends.”
Most policies provide some degree of coverage for “sudden and accidental” damage. This might include bursting pipes, sewage backups or other events. However, not all water damage is sudden; much of it happens slowly, over time, as a result of unknown leaks, maintenance oversights and other causes.
That slow-forming water damage is something insurance companies frequently try to exclude from coverage. The language they use is often something like, “We do not insure for losses caused by leakage of water occurring over a period of X days or longer.”

Dealing With the Adjuster and Denied Claims

As you might imagine, determining exactly how many days a pipe might have been leaking is not an easy task. Not surprisingly, insurance adjusters use that to their advantage when evaluating a situation. Adjusters frequently overstate how long a leak may have been ongoing in order to deny the claim and save the insurance company some money.
Often, if the claim isn’t outright denied, it will be underpaid. We advise business owners to get a second opinion from a public adjuster if your own insurance company denies your claim or offers a low settlement. A second opinion is highly recommended if your claim was denied due to any of the following:
- Long, ongoing leak
- Unrepaired leak
- Preventable maintenance issue
- Failure to mitigate damages
- Burst or broken pipe caused by failure to keep electricity or heat in the building
Getting Help for Water Damage Claims

After sustaining water damage to your business, you don’t have a lot of time to spend fighting with your own commercial insurance company. Remember, your insurance policy is a contract. If you believe the insurer is not living up to its end of that contract, consider reaching out to an experienced lawyer for advice.
The Fell Law Firm has deep experience in commercial insurance litigation, including cases involving water damage and denied claims. Mr. Fell can meet you, assess your options and advise you accordingly. Contact us today!
July 17, 2019
Commercial Insurance Claim Denial: How to Fight Back

When you purchase commercial insurance to protect your business, you expect to be able to rely on your coverage. Through fire, flood, theft or other damaging events, your insurance policy is a contract you should trust. What happens when your commercial insurance company decides to deny your claim?
Insurance Companies Don’t Expect You to Fight Back
Most insurance companies process claims expecting that the business on the receiving end of a denial won’t try to fight it. They may attempt to minimize your claim or narrowly interpret your policy to refuse your claim. Without understanding your policy, your rights and the steps you can take to fight back, you may find yourself throwing your hands up or wanting to simply throw in the towel.
What to Do After Your Insurance Claim Is Denied
If you’ve received a denial for a commercial insurance claim, it doesn’t necessarily signify the end of the line. There are several steps you can take to fight back, ensuring you do everything in your power to pursue your claim.
Understand why your claim was denied. It’s important to read the notice you receive carefully to outline the reasoning behind your insurance company’s decision. For instance, they may dismiss your claim because you failed to submit it on time, the event you’re seeking coverage for isn’t a covered loss or they believe your claim is fraudulent.
Examine your policy. Carefully examine your policy for covered events, time limits and procedures.
Write an appeal. If you can’t find any indication as to why your insurance company denied your claim, you can choose to write an appeal letter. Use the space to outline your argument based on your policy and provide any supporting evidence. The appeal you write may make or your break your ability to receive reimbursement, so you may want to work with an attorney to draft as persuasive of an appeal as possible.
Move forward towards litigation. If the company still denies your claim that you believe your policy covers, you can choose to sue your insurance company. Consider calling a professional commercial insurance attorney to help you decide if this is the next best step for you.
You Don’t Have to Accept an Insurance Claim Denial
Most business insurance claims involve loss, whether monetary, physical property or both. If your claim is denied, you don’t have to simply succumb to your losses. To learn more about fighting back after a claim denial, send us a message.

May 15, 2019
Filing a Commercial Insurance Claim After a Business Burglary

A study completed by a prominent insurer uncovered a surprising fact: four out of 10 small businesses will likely file commercial insurance claims in the next 10 years. The study predicted that burglary or theft would be the most likely reasons for the claims. Burglary and theft claims make up about 20 percent of all commercial claims.
Hopefully, your business is never burglarized or becomes the victim of any other type of theft. But, problems can spring up when you least expect them. That’s why carrying the right insurance coverage and working with the right law firm can be critical to your success.

What to Do After a Business Burglary

If your business is burglarized, the first step is to call the police to file an official report. You’ll need the report to file an insurance claim. But the police can help you in other ways, too. They can examine the scene for evidence and interview potential witnesses. Keep in mind, however, that most property that is stolen from businesses is never recovered in sell-able condition.
The police can also help you secure your store, so you do not experience further losses. You’ll want to make temporary repairs to any broken windows or locks (but wait to talk with your insurer before making expensive permanent repairs). If your security system has been taken offline, you’ll want to reset it as soon as possible. It’s also advisable to make a detailed list of everything that was stolen so that you know the extent of the damages your business has experienced.

Deciding Whether to File an Insurance Claim

After talking with the police, talking with your insurance company is the next step. However, many business owners worry about filing a claim. They do a cost-benefit analysis and determine that the items stolen were worth less than the deductible. They also worry that their insurer will raise rates or drop them if they file a claim.
These are valid points. However, you carry commercial insurance precisely so that you are covered in the event of burglary, theft or other losses. If you don’t file now, you’re never gaining the benefit of something that you pay for every month. Further, the expenses of fixing the damage and replacing stolen goods could be more than you’re currently estimating. The average theft or burglary claim is $8000.

What if a Your Insurance Claim is Denied?

Hopefully, your insurer pays the claim without any hassle. But, there are many reasons that insurance companies deny business burglary claims—and not all of them are legal. If you suspect that your insurance company isn’t acting in good faith, it may be time to talk with a lawyer. The attorneys at The Fell Law Firm can help with denied insurance claims.
To talk with an attorney at The Fell Law Firm, just call 972-450-1418 for a free and confidential consultation. We can help you weigh your options and protect your business.

September 21, 2018
The Most Common Reasons for Commercial Insurance Claim Denials
Commercial insurance protects businesses in the event of property damage from fires, water leaks, vandalism, and other events. It should provide the financial resources for restoring the business to pre-loss conditions while maintaining it during repair.
Unfortunately, many business owners never receive this compensation. Their insurers deny their commercial insurance claims, refusing to pay the proper amount.

Top Causes for Insurance Claim Denials

Here are some of the most common reasons that insurers deny commercial insurance claims:
- Alleged delays in filing the claim: Most policies have strict time limits for reporting commercial property damage to the insurer. A delay in reporting can become a reason for the insurer to deny the claim.
- Alleged premium payment lapses: Even a small lapse in payment can become a reason for an insurance company to deny a business insurance claim. Ensuring continuous coverage is key to protecting your business.
- Insufficient documentation: Careful documentation is necessary to establish that the damage occurred. For that reason, many business owners prefer to work with a lawyer from day one. Business owners can get the guidance they need to provide the right information the first time—avoiding any unnecessary delays or denials. (Of course, even when business owners provide the right information, insurers sometimes act in bad faith and say they did not receive it. If this has happened to you, call an attorney.)
- Exclusion clauses: Some business insurance policies exclude certain types of damage, like flood damage, for example. If your policy excludes the type of damage you experienced, your insurer will likely refuse to cover it. It’s critical to thoroughly read and understand your policy before harm occurs.
- Failing to mitigate the damage: Most insurance policies require business owners to take certain steps to limit the extent of the damage. If they allegedly do not, the insurance company may not compensate them for all of the harm done to the property.
Has Your Insurer Denied Your Claim?

No matter why your insurance company denied your commercial insurance claim, one thing is true: it is critical to take decisive action quickly. You only have a limited amount of time to appeal the denial or you may waive your right to take action. Your lawyer will need time to assess the situation and put together a strong argument on your behalf. It is important to act as soon as you anticipate trouble.
We are standing by now to help. To talk with an attorney at The Fell Law Firm in Richardson, call 972-450-1418. Consultations are confidential.
April 11, 2018