Insurance providers are supposed to offer peace of mind. Whether it’s for medical treatment after an accident, property damage, or other covered events, you expect your insurer to honor a valid claim promptly. Unfortunately, many South Carolina residents face frustrating delays or denials in their insurance claims. If this has happened to you, you’re not alone ,and you do have legal options.
In this guide, we’ll explain common reasons insurance claims get denied or delayed, your rights under South Carolina insurance law, and the steps to challenge unfair denials or improper claim practices to get the settlement of claims you deserve.
Common Reasons for Insurance Claim Denials or Delays
Insurance companies prioritize their bottom line, sometimes at the expense of policyholders. While some delays or denials stem from legitimate policy provisions or policy defense, others are caused by unclear communication or bad faith insurance claims tactics:
- Incomplete or Inaccurate Claim Documentation
Many claim denials result from missing or incorrect information on claim forms or proof of loss documents. Insurers may deny clean claims rather than requesting clarifications. - Policy Exclusions and Coverage Limits
Insurers may deny claims citing policy exclusions or limits, sometimes applying these provisions unfairly or in bad faith. - Disputes Over Liability or Valuation
Accident claims often face disputes regarding who is at fault or disagreements over the payout amount. Such disputes can delay timely payment or lead to underpayment. - Bad Faith Insurance Practices
South Carolina law prohibits insurers from engaging in bad faith conduct ,intentionally delaying or denying claims to pressure policyholders to accept less or give up. This includes failing to conduct a prompt investigation and refusing to follow reasonable standards.
South Carolina Legal Protections for Policyholders
South Carolina Code § 38-59-20 requires insurance providers to respond promptly and fairly to claims. They must acknowledge receipt of your claim within 30 days and make decisions without unnecessary delay or improper claim practices.
If your insurer breaches the contract or acts in bad faith, you may be entitled to file a bad faith lawsuit. This can include seeking punitive damages and attorney fees beyond your original compensation claim.
The South Carolina Unfair Trade Practices Act also protects policyholders against repeated, unjustified claim denials or delays.
If you face a claim denial or delay, follow these steps:
- Review Your Policy and Policy Provisions
Carefully examine your insurance policy for coverage limits, exclusions, and the claims process. Understanding your policy helps identify if the denial is justified or a breach of contract. - Request a Written Explanation
South Carolina law allows you to request a detailed written explanation from your insurer, including the specific reasons and policy provisions used to deny your claim. - Gather Documentation
Compile all supporting materials ,photos, medical records, repair estimates, police reports, and any communications with your insurer. This evidence is crucial if you file an internal appeal or take legal action. - File an Internal Appeal
Use the insurer’s appeals process to formally dispute the denial or delay. Submit additional evidence and keep detailed records of all communications. - File a Complaint with the South Carolina Department of Insurance
If you’re unable to resolve the issue, the Department of Insurance can investigate bad faith insurance claims and improper claim practices. - Consult an Experienced Attorney
When insurance denials or delays threaten your financial stability or medical care, consult a personal injury lawyer or insurance claim denial attorney experienced in South Carolina insurance law.
Delays Can Be as Harmful as Denials
Even if your insurance claim isn’t formally denied, unreasonable delays can harm you by withholding timely payment and increasing stress. Watch for signs such as repeated requests for the same documents, lack of response from your claims adjuster, or no clear timeline for a decision. These tactics often violate reasonable promptness standards and may justify legal action.
When to Take Legal Action
If you’ve complied with all policy requirements and still face denial or delay, legal action may be necessary. Grounds for a lawsuit include breach of contract, bad faith conduct, emotional distress, and financial damages caused by the insurer’s improper claims practices.
How Ted Law Firm Can Help with Insurance Claim Issues
At Ted Law Firm, we specialize in helping South Carolina residents with insurance claims ,from denied accident claims to delayed property damage settlements. Our team will:
- Review your policy and identify your legal rights
- Communicate directly with insurance providers on your behalf
- Assist with filing appeals and complaints
- Pursue equitable settlement or legal action, including bad-faith lawsuits
We are committed to holding insurance companies accountable and securing timely, fair compensation for you.
Tips to Prevent Future Insurance Claim Problems
- Read and understand your insurance policy and policy provisions before you need to file a claim.
- Document everything thoroughly from the moment an incident occurs.
- File claims promptly and keep copies of all documents and communications.
- Confirm all verbal agreements in writing.
- Never sign any settlement or release without consulting a lawyer.
Insurance claim denials and delays are common, but you don’t have to accept bad faith treatment. Understanding your rights under South Carolina insurance law and taking prompt, informed action can help you get the compensation you deserve. We proudly serve injury victims in Aiken, Anderson, Columbia, Charleston, Myrtle Beach, North Augusta, Orangeburg, and Summerville. If you’ve been injured due to someone else’s reckless or criminal behavior, our experienced attorneys are here to help you seek justice and recover the compensation you deserve. Let Ted Law Firm help you file a successful claim for emotional damages. Call us today for a free consultation and start your journey toward healing and compensation.
If you’re facing an insurance claim denial or delay, don’t wait. Contact Ted Law Firm for a free consultation and let us help you fight for your rightful settlement today.
