Chicago Insurance Claims Denial Attorneys

insurance claims denial attorneys

If you or a loved one get injured, you should be able to count on your insurance carrier to cover the expenses agreed upon under the terms of the policy. If your injury was caused by the careless or negligent actions of another person, you should be able to rely on their insurance carrier to pay for all injury-related expenses.

However, an insurance carrier denies your claim, you need to speak to a skilled attorney as soon as possible. At Horwitz, Horwitz & Associates, our qualified and experienced Chicago insurance claim denial attorneys are ready to investigate every aspect of your case and ensure you are treated fairly and receive the compensation you deserve.

Why choose Horwitz, Horwitz & Associates?

In the aftermath of being notified that your claim has been denied, you need to seek assistance from an attorney with extensive experience handling these types of cases. At Horwitz, Horwitz & Associates, we are ready to get to work on your case.

  • For three generations, our Chicago personal injury and workers’ compensation attorneys have represented injury victims, helping them secure millions of dollars in compensation through settlements and verdicts.
  • Our Chicago injury attorneys do not look to take the easy settlement or compensation that does not cover all of your expenses. We will take your case all the way to trial if that is what is necessary.
  • You can count on individualized representation at our firm. At Horwitz, Horwitz & Associates, we take the time to get to know each client so we can fully understand their goals.
  • Our team takes these cases on a contingency fee basis, which means we only collect legal fees after we secure the compensation you are entitled to.

Why is an attorney necessary for these cases?

Having an attorney will be an invaluable asset to a claim denial case. Most individuals do not have the legal knowledge or resources available to properly fight a claim denial. Your Chicago claim denial lawyers will be responsible for:

  • Investigating the entire case and obtaining all evidence related to the injury.
  • Thoroughly reviewing your insurance policy and the claim denial letter.
  • Working with medical professionals to ensure you are cared for and that an expert medical witness can testify on your behalf.
  • Negotiating with all parties involved to ensure you receive the compensation you are entitled to.

When does a claim denial happen?

It is important to understand that insurance companies are “for-profit” entities. Their goal is to make as much money as possible, and they do so by paying as little as possible in settlements. This means that insurance carriers often use tactics that are ethically questionable in order to pay as little as possible for your claim. This includes outright denials of some claims.

There are various types of insurance claims denials that the attorneys at Horwitz, Horwitz & Associates help clients deal with. We have vast experience handling the following types of insurance claim denials.

Workers’ compensation

Even though workers’ compensation is supposed to guarantee that an injured employee will receive compensation for medical bills and lost income after sustaining an injury at work, these claims are often denied by the insurance carrier or the employer. Workers’ compensation insurance is a “no-fault” system, which means that the injured worker should receive compensation regardless of who was at fault for the injury. Unfortunately, a claim may be denied for various reasons, including:

  • The employer denying that the injury happened at work.
  • The injured worker not receiving appropriate medical care.
  • The employer saying that the worker caused the injury due to gross negligence or intentional actions.

Car accident claims

If you are injured in a car accident, you should be able to count on coverage from either your insurance carrier or the insurance carrier of the at-fault party. However, claim denials by car insurance carriers are not uncommon and they can put victims and incredibly difficult situations. One example of this is USAA, an insurance carrier that specializes in catering to members of the Armed Services and their families. USAA has an “F” rating with the Better Business Bureau and has faced many lawsuits for unfairly denying insurance claims.

Health insurance claims

When you have health insurance, whether through your employer or coverage you have purchased on your own, you should be able to count on your insurance carrier to cover you for valid claims made under the policy terms. Unfortunately, insurance carriers are notorious for denying claims. This can happen for various reasons, including:

  • Getting medical care outside of the insurer’s network.
  • Not following all procedures laid out in the policy.
  • The insurer deeming the care not medically necessary.
  • Insufficient information sent to the insurer about the procedure.

Other personal injury claims

There are many other ways that insurance denials can affect an injured victim. This can include a denial by an insurance carrier after an injury caused by the negligent or careless actions of a property owner. In a premises liability lawsuit, property owners typically turn to either business insurance or homeowner’s insurance to cover the claim.

What can you do about an insurance claim denial?

There are several steps that a policyholder can take after receiving a claim denial letter from the insurance carrier. Briefly, this can include:

  • Thoroughly reviewing the reason for denial. Before you can fight a denied claim, it is important to understand exactly why it was denied. Thoroughly review your insurance policy as well as the denial letter. At this point, it would not hurt to secure a Chicago claim denial attorney who can assist you with this process.
  • Learn what the appeals process is. Every insurance company will have a policy in place for a policyholder to appeal a denial. Learn about this process, including all deadlines in place for an appeal denial.
  • Gather evidence. You want to be sure that you have all the evidence necessary to back up your insurance claim. This includes all medical records related to the initial claim.
  • File a lawsuit. If your claim is still denied by the insurance carrier after you appeal, you may have to file a lawsuit in order to recover the compensation you deserve. Speak to a skilled claim denial attorney in Chicago about your case. Your attorney will be able to help you navigate this entire process as you work to go up against the aggressive insurance carrier.

Evidence of bad faith insurance claim denial

It is generally understood that insurance carriers have an obligation to operate in good faith and fair dealing with every policyholder. When an insurance company fails to act reasonably when processing, investigating or paying a claim, then the policyholder may have the right to file a lawsuit alleging bad faith.

There are various ways that an insurance company can operate in bad faith and end up denying the claim. Proving bad faith on the part of the insurance carrier generally involves two elements. This includes:

  1. Showing that the rightful benefits under the policy were withheld. The policyholder needs to establish that they had a valid claim under the terms of their policy. They will need to show that their claim was denied by the insurer. In some cases, a policyholder will be required to make a final demand (usually in the form of a letter) to the insurance carrier for payment.
  2. Showing that the reason for withholding benefits was unreasonable. It will need to be determined that the denial of benefits was an unreasonable move by the insurance carrier. This will be shown by objectively evaluating the situation and facts as they existed at the time the decision was made by the insurance carrier.

Courts have found that several types of behavior can constitute bad faith by an insurer. This can include the insurer:

  • Misrepresenting relevant facts or provisions of the insurance policy.
  • Failing to acknowledge a claim or to act promptly after receiving a valid claim.
  • Failing to properly investigate the claim made by the policyholder.
  • Failing to approve or deny a claim within a reasonable amount of time after the policyholder submits the claim.
  • Failing to provide reasonable explanations or reasons for denying a claim.

Contact a Chicago Insurance Claim Denial Attorney

If you or somebody you love has been injured but have received notice that your insurance claim has been denied, seek legal assistance immediately. At Horwitz, Horwitz & Associates, our knowledgeable and experienced team is ready to get to work investigating your case in order to secure the compensation you are entitled to. This could include:

  • Coverage of all injury-related medical expenses
  • Your lost wages and benefits if you cannot work while recovering
  • Coverage of household expenses
  • Pain and suffering damages
  • Punitive damages in instances of bad faith

Do not hesitate to stick up for yourself in these situations. Insurance companies are “for-profit” entities that will do everything they can to limit the amount of money they payout. This is not fair policyholders, and we are ready to help you fight back. If you need a Chicago claim denial lawyer, you can contact us for a consultation of your case by clicking here or by calling (312) 372-8822.