What if My Claim Was Not Investigated by My Insurance Company?

Claim Was Not Investigated by My Insurance Company.

If your insurance company fails to investigate your claim in a timely manner, they could be acting in bad faith.  Insurance company bad faith is a legal term that describes when an insurance company fails to investigate a claim in good faith or acts to the detriment of their policyholder.  Insurance companies are obligated to investigate and process claims in a timely manner.

What is a Bad Faith Investigation?

A “bad faith” insurance investigation is when an insurer fails to honor their policy obligations.  It can involve investigations into the merits of a claim, or if the policyholder has been subjected to unfair treatment.  Bad faith investigations may also include questioning of the insurers’ practices, such as if they have acted in good faith or if there was a conflict of interest between insurer and policyholder.

Here is what you can do if your insurance company does not investigate your claim:

1. Hire an attorney:  If your insurance company won’t budge on investigating the claim, it may be time to hire an attorney specializing in insurance law who can help you get the results you need.

2. Request more information:  An attorney should request more information from your insurer regarding why they are refusing to investigate your claim or what steps they are taking when it comes to investigating it.  When an insurance company denies a claim outright, they are required to provide you with a written response why your claim was denied.  Make sure you keep this and any other documentation you receive from your insurance company.

3. Appeal your claim:  Most insurers have an internal appeals process that allows customers to appeal rejected claims or disputes other decisions made by insurers during the claims process.  If you must go this route, it might be a good idea to speak with a legal advocate first, as insurance companies may not want to pay out your claim.

4. Take legal action:  If all else fails, consider taking legal action against your insurer for breach of contract if they fail to properly investigate and pay out on valid claims in a timely manner.  This is also something you will want to seek legal advice on making sure you are following the proper steps.

5. File a complaint with your State Insurance Commissioner:  Every state has an insurance commissioner responsible for regulating the insurance industry and providing consumer assistance.  File a complaint with the commissioner’s office to try to resolve your issue.

6. Contact your state’s Department of Insurance:  Depending on the state, you may be able to contact their Department of Insurance directly to file a complaint against your insurer and compel them to investigate your claim or answer any questions you may have about the process.

If you think your insurance company is failing in their duty to fully and adequately investigate your claim, take action immediately.  Speak with the experienced Plainfield area insurance lawyers at Herold Law, P.A.  Contact us at 908-647-1022 or fill out our online form today.  With offices in the Plainfield area including Warren, New Jersey, we proudly serve clients all across New Jersey.