Dealing with an insurance company after an accident or disaster can be an overwhelming experience. When your valid claim is denied or delayed, the frustration is multiplied, especially if you rely on timely payment to cover medical care, repair damages, or other urgent expenses. Whether you are filing an accident claim, a life insurance claim, or any other clean claims, understanding your rights and the claims process under insurance law in Georgia is crucial.
Understanding Insurance Claim Denials and Delays
Insurance companies operate as businesses, often prioritizing profit over fair settlements. This sometimes leads to improper claim practices or bad faith insurance claims, such as denying claims without proper investigations or breaching their policy provisions. These practices can involve a breach of contract if they fail to act according to the terms of your policy.
Common reasons for claim denials include:
- Alleged policy defense citing policy exclusions
- Missed deadlines or incomplete claim documentation
- Disputed third-party liability claims, especially in accident claims
- Claims related to pre-existing damage or material misrepresentation
- Non-payment of premiums leading to coverage lapses
Delays may be caused by inadequate staffing, ongoing investigations, or deliberate stalling as part of improper claims practices.
Legal Protections and Your Rights
Under Georgia law, insurers are required to act with reasonable promptness and follow reasonable standards in handling claims. The Prompt Payment Statute and Fair Claims Settlement Practices Act prohibit bad faith conduct, including delaying claims without valid reasons or refusing to pay valid claims.
If your claim has been unfairly denied or delayed, this may constitute a bad faith claim. You could be entitled to punitive damages, attorney fees, and compensation beyond the original claim amount. An experienced attorney or insurance claim denial attorney specializing in bad faith insurance claims can guide you through the appeals process and, if necessary, help you pursue legal action.
Step-by-Step: What To Do If Your Insurance Claim is Denied or Delayed
- Read the Denial Letter Carefully: Georgia law requires insurers to provide a written explanation, which helps determine if there was a breach of contract or improper claims practices.
- Gather All Documentation: Collect your policy, claim forms, police reports, accident reports, treatment plans, and photos or videos supporting your personal injury claim or property damage.
- Request a Written Explanation: If the insurer’s reasons are unclear or verbal only, ask for written details. This protects your rights.
- File an Internal Appeal: Use the insurer’s appeal process and submit any additional evidence or claim documentation.
- Contact the Georgia Office of Commissioner of Insurance and Safety Fire: If you suspect bad faith, file a complaint.
Common Types of Denied or Delayed Claims
- Auto Insurance Claims: Liability disputes and bodily injury claims are frequent reasons for denial or delay.
- Homeowner’s Insurance: Damage claims due to storms or fire often face claim denials or delays.
- Health Insurance: Denials may concern health insurance coverage, disputed treatment plans, or medical condition issues.
- Life Insurance Claims: Life insurance companies sometimes deny claims alleging material misrepresentation or incomplete information.
When to Consult a Personal Injury Lawyer or Insurance Attorney
If you face denial despite submitting a valid claim and following reasonable standards, consulting a personal injury attorney or bad faith insurance attorney can be crucial. They can evaluate your claim under the claims process, negotiate a reasonable settlement, and pursue legal action if necessary to ensure equitable settlement and timely payment.
Tips to Strengthen Your Claim
- Keep detailed records of all communications with respect to your claim.
- Obtain copies of adjuster reports, claim review documents, and any claim payment checks.
- Document all damage with photos or videos.
- Avoid accepting low offers resulting from improper claims practices.
Real-World Examples
- A driver’s personal injury claim initially denied over fault disputes was later approved after submitting a police report and video evidence.
- A homeowner endured delays on a property damage claim until an attorney intervened, securing payment with interest under the Prompt Payment Statute.
Common Mistakes to Avoid
- Accepting verbal claim denials without written proof.
- Missing deadlines for the appeal process.
- Settling too quickly without legal advice.
- Failing to document all interactions or submit complete claim documentation.
Protect Your Rights Act Now
If your insurance company refuses to honor a valid claim or engages in bad faith insurance claims, do not hesitate to seek legal help. Understanding your rights under insurance law and holding insurers accountable for breach of contract and improper claim practices can protect your financial future.
Contact Ted Law Firm
If you are struggling with a delayed or denied insurance claim in Georgia, contact Ted Law Firm today for a free case review. Our experienced attorneys specialize in handling accident insurance claims, life insurance claims, and personal injury claims with dedication and skill. We fight for your rights and work to secure the compensation you deserve no games, no delays. Our dedicated personal injury attorneys will guide you through every step and help secure the justice your family deserves. Let Ted Law Firm handle the legal stress while you focus on healing. In addition to Georgia we also proudly help people in Atlanta, Columbus, Macon, Athens, Savannah, Warner Robins, and all of Georgia! We advocate for accident victims across South Carolina and Georgia. We fight for fair compensation – even when insurance companies don’t.
Attorney Ted Sink, founder of The Ted Law Firm, is a Yale, Stanford Business School, and Charleston School of Law graduate and former marketing executive who built a 7-figure law practice, earning millions for his clients. With experience in both law and advertising, Ted has been recognized in Forbes, Entrepreneur, and the ABA Journal. He speaks at industry conferences on marketing and law firm management, sharing insights from his unique background to help other firms grow. When not working, Ted enjoys traveling, diving, and dog-sitting golden retrievers.
