When Insurance Won’t Pay

From renters or homeowners insurance to auto, health, and disability coverages, the average person spends a lot of money each year on insurance premiums. But most people don’t suffer large losses and, as a result, have very little experience dealing with insurance companies on large claims. The unlucky ones who do file such claims, may be in for a bit of a surprise. If insurance won’t pay, it is important to know your consumer rights and seek legal counsel.

Consumer Insurance Complaints

The National Association of Insurance Commissioners (NAIC) tracks the most common complaints filed by consumers each year. The most common complaint is delays when waiting for a claim to be processed, followed by claim denials, and insufficient amounts paid out by a carrier on a claim. And, the most commonly denied claims are for accident and health insurance policies with the next biggest offender being auto insurance. A fact that cannot be overlooked is that an Insurance Company’s business plan is to collect premiums and minimize claims to increase profits. They are motivated to take in money and not pay out money.

Unfair Claims Practices

By Law, any of the following acts could constitute unfair claims practice by an insurance carrier in Oregon.

• Misrepresenting facts or policy provisions in settling claims

• Failing to acknowledge and act promptly upon communications relating to claims

• Refusing to pay claims without conducting a reasonable investigation based on all available information

• Not attempting, in good faith, to promptly and equitably settle claims in which liability has become reasonably clear

• Compelling claimants to initiate litigation to recover amounts due by offering substantially less than amounts ultimately recovered in actions brought by such claimants

A Particular Problem Area

In Oregon, you have no-fault Personal Injury Protection (PIP) coverage as part of your auto policy. This coverage is designed to provide health and wage loss benefits if you are injured in a car, bike or pedestrian accident. Unfortunately, insurance providers deny payment of these claims all the time. They say the medical care is not necessary or it’s not related. They say “We don’t believe this accident caused your injury”. They send you to a doctor of their choice (because they have a right to do so under the policy). Of course, these doctors work for the insurance company and they say there’s nothing wrong with you, or that you don’t need care, or that you didn’t need half of the care you received. That’s where our firm steps in. We have to fight for our clients all the time and have a pretty high success rate with these types of cases.

If you’ve been denied on a claim and the insurance won’t pay, you shouldn’t hesitate to contact the Law Office of Brian Whitehead. As a personal injury law firm, we deal with insurance companies on a daily basis. In some cases, we file suit against a defendant that is represented by an insurance company. In other cases, we represent clients in first party claims. A first party claim is a claim by an individual directly against their own insurance company for a failure to pay a claim covered by an insurance policy.

To speak with an attorney at our firm about an insurance claim, call now 503-364-8505.

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