DISPUTES WITH INSURANCE COMPANIES
Imagine that a person has an insurance contract with an insurance company to protect themselves from possible, unpredictable consequences that could completely destroy or partially damage a property, such as an accident, flooding, fire, other mechanical damage, etc.…
One of the described cases occurred and the person applied to the insurance company for insurance compensation for the relevant insured event, but was denied payment, or received a payment which amount is much less than expected.
INSURANCE DISPUTE LAWYER EXPLAINS HOW AND WHY DISPUTES WITH INSURANCE COMPANIES ARE
Disputes with insurance companies can arise for many reasons, ranging from the insurer’s reference to non-compliance with the terms of the contract at the time of violation of the procedure for warning of the insured event, ending with attempts to underestimate the actual damage under the insurance contract. However, the insurance contract may provide provisions that establish the dependence of the amount of insurance payment on the insurer’s assessment of the probability of occurrence of the insured event, which in turn depends on the condition and other characteristics of the insured, such as security, fire extinguishers, location, etc.…
The insurance lawyer notes that the most common grounds for refusing to pay insurance indemnity are:
- Full compensation for losses of the insured by the person who caused them;
- Violation by the insured of the terms of notification of the insured event to the insurer without good reason;
- Submission by the insured of knowingly false information about the subject of the insurance contract or about the fact of the insured event;
- Committing by the insured or another person in whose favor the contract is concluded, an intentional crime that led to the insured event.
However, notwithstanding the above and in case of refusal of insurance payment or reduction of its amount, the insured has the right to seek protection of their rights in court.
EXPLANATION OF THE INSURANCE DISPUTE ATTORNEY CONCERNING THE DOCUMENTS REQUIRED TO CONFIRM THE INSURANCE OF THE INSURANCE CASE AND SUBSTANTIAL REASONS
Payment under the insurance contract is assigned directly to the insured person in any case other than his death. The following documents must be submitted to confirm the insured events:
- Application for payment of the amount under the insurance contract;
- A copy of the insurance contract;
- Identity documents;
- Medical certificates of damage to health, or certificates of property damage;
- Relevant documents of the medical institution, which allow to establish the amount of insurance indemnity, which indicate the consequences of injuries for working capacity, health, as well as information about possible complications, or documents, which allow to establish the amount of insurance indemnity for material damage;
- Certificates confirming the cost of treatment or the cost of repairing material damage, etc.…
- Payment for the insured event directly depends on the provision of documents confirming the events that led to the insured event.
INSURANCE LAWYER PROVIDES LEGAL SUPPORT PROTECTION OF THE INSURER’S RIGHTS
The protection of the rights of the insured can be divided into several stages, namely:
- Analysis of the circumstances of the case and the relevant regulatory framework;
- Attempt to resolve the dispute through negotiations;
- In the presence of conditions and corresponding circumstances preparation and submission of the claim;
- In the absence of an opportunity to resolve the issue at the pre-trial stage, it is necessary to analyze the case law and assess the chances of winning in court, in a dispute with the insurer;
- Preparation of a statement of claim and relevant materials in order to apply to the court;
- Execution of a court decision in case of dispute resolution in favor of the insured.
herefore, disputes with insurance companies have certain specifics and require special knowledge, especially when it comes to a considerable amount of money to be obtained, we advise you to use the services of a professional lawyer who specializes in this area.