reasons why you need a lawyer when dealing with insurance companies

by Alvis Quitzon 6 min read

Here are some reasons why obtaining a lawyer is a good idea when dealing with insurance companies: They can help you avoid unfair settlement offers. You’ll have someone who knows the process and how to fight them in court.

Even the insurance industry recommends a lawyer—to a certain point.
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This could include:
  • Claims where you and the insurance adjuster don't agree early on.
  • Expensive or complex claims.
  • Large claims, such as house damage after a fire, extensive water problem or tornado.
  • Claims where fault is hard to establish.
Oct 21, 2020

Full Answer

Why do I need a lawyer for a car insurance claim?

An experienced lawyer can see the claim from all sides and know if there is any chance of getting the insurance company to reverse its position. “Insurance companies are not afraid to deny a claim using shaky reasoning because an unrepresented claimant has no ability to seek a remedy in court.

What do insurance companies do when you don’t have an attorney?

“Insurance companies use a couple of tactics with people who are not represented by attorneys,” she explains. “If they know there is a valid claim, they will make a quick low offer in hopes that you take the money and run.

Do I need a lawyer to review my life insurance policy?

“If your claim is not a simple one and may involve interpretation of the policy, it is sometimes best to consult an attorney,” says Pamella Seay, who teaches justice studies at Florida Gulf Coast University. “Some attorneys may provide you with a review to give you some guidelines on what to do on your own, though most will not.

Do I need a lawyer for a personal injury claim?

Ryan Babcock, an attorney with the Babcock Law Firm, a personal injury law firm in Georgia, says lawyers are sometimes necessary to overcome the insurance industry’s practices in dealing with claims.

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How do I fight an insurance company?

If you are not satisfied with your health insurer's review process or decision, call the California Department of Insurance (CDI). You may be able to file a complaint with CDI or another government agency. If your policy is regulated by CDI, you can file a complaint at any time.

Why do people sue insurance companies?

You can sue your insurance company if they violate or fail the terms of the insurance policy. Common violations include not paying claims in a timely fashion, not paying properly filed claims, or making bad faith claims.

How do you scare insurance adjusters?

The best way to scare insurance carriers or adjusters is to have an attorney by your side to fight for you. You should not settle for less.

Can insurance companies refuse to cover you?

Getting Coverage No insurance plan can reject you, charge you more, or refuse to pay for essential health benefits for any condition you had before your coverage started. Once you're enrolled, the plan can't deny you coverage or raise your rates based only on your health.

Why would an insurance claim be denied?

There are several reasons insurance companies deny claims that are valid and reasonable. For example, if your accident could have been avoided or if your conduct led to the accident, your claim may be denied. An insurance company may also deny a claim if you have engaged in conduct that renders your policy ineffective.

What is it called when an insurance company refuses to pay a claim?

Bad faith insurance refers to an insurer's attempt to renege on its obligations to its clients, either through refusal to pay a policyholder's legitimate claim or investigate and process a policyholder's claim within a reasonable period.

What happens if you don't agree with insurance adjuster?

The company must grant you this right and assign someone within the insurance company to look at the facts of your case and determine whether the adjuster made a mistake. If an internal review fails to reverse the adjuster's decision, you can file an official complaint against the insurance company.

What should you not say to an auto insurance adjuster?

Never say that you are sorry or admit any kind of fault. Remember that a claims adjuster is looking for reasons to reduce the liability of an insurance company, and any admission of negligence can seriously compromise a claim.

Why does insurance adjuster want to meet with me?

What Does The Insurance Adjuster Want From Me? The insurance adjuster wants to obtain a statement from you. The insurance adjuster wants to discover how you viewed the accident. If you tell a different story of how the accident occurred, they will use the fact that you made two different statements against you.

What pre-existing conditions are not covered?

Health insurers can no longer charge more or deny coverage to you or your child because of a pre-existing health condition like asthma, diabetes, or cancer, as well as pregnancy. They cannot limit benefits for that condition either.

Is arthritis a pre-existing condition?

Arthritis is generally considered pre-existing medical condition. This doesn't necessarily mean you can't get travel insurance, but you do need to disclose your condition before you book your cover. With arthritis, you'll need to declare your specific type of arthritis whether it's osteo, rheumatoid, or psoriatic.

How do insurance companies decide what to cover?

Insurance companies determine what tests, drugs and services they will cover. These choices are based on their understanding of the kinds of medical care that most patients need. Your insurance company's choices may mean that the test, drug, or service you need isn't covered by your policy.

How many homes have water damage claims?

Roughly one in 50 insured homes have a property damage claim caused by water damage or freezing each year, according to the Insurance Information Institute. And about one in 20 insured homes has a claim each year. When should you contact a lawyer? How do you even know if an attorney can help?

What is the best strategy for a large claim?

Another good strategy for a large claim is hiring a public insurance adjuster. For example, after extensive home damage a public adjuster can work with you to get paperwork done, meet deadlines and advocate for you.

Why are insurance companies not afraid to deny a claim?

“Insurance companies are not afraid to deny a claim using shaky reasoning because an unrepresented claimant has no ability to seek a remedy in court.

What is the purpose of asking innocent sounding questions?

Those include asking innocent sounding questions to gather information that ultimately hurts the person’s case, or closing the claim long before all medical bills, and necessary medical treatment, or lost wages, or pain and suffering, are even known.”.

Can a small claim settle without a dispute?

Small run-of-the-mill claims usually settle without trouble. But in cases where there’s more at stake—for both you and the insurance company—there may be a higher chance for dispute. This could include: Claims where you and the insurance adjuster don’t agree early on. Expensive or complex claims.

Who is Tina Willis?

Tina Willis, a personal injury lawyer in Orlando, Florida, says determining the value of an attorney is a simple numbers game. Often, insurance companies agree to settle a claim without being specific about the settlement amount. And that is—often literally—the million-dollar question.

Did November have to replace the adjuster?

And that’s when he and his wife decided to lawyer up. Which was easy for November because he is a lawyer. November asked the insurance company to replace the adjuster, which it did. The new adjuster, a fellow Clevelander, understood the extent of the damage to November’s home and helped him get the full claim approved.

A Lawyer Can Present Your Case Strongly

Let’s say, for instance, you get injured at work. It is your employer's workers' compensation insurance that pays for nearly all of your medical bills and part of your lost income. Although the workers' compensation process doesn't always require an attorney to be present, you can benefit from one if the case appears complicated.

The Law is Complicated

The law is complicated enough on its own, so when you add in the fact that this is something involving your own life, you can see how it would be very difficult to go at it alone. The law is not a one-size fits all sort of thing, and each case is going to be different from the next.

Lawyers Know How to Challenge Evidence

In order to win a case, the lawyers must know how to challenge evidence. You as a layperson may not understand or comprehend as well as an experienced lawyer how to deal with the existing admissible evidence.

Lawyers Know How to Negotiate Settlements and Plea Bargains

If you don't know how to negotiate, lawyers know the right way to approach it and they are good at negotiation. They can help you get your case plea bargained or settled in a way that will reduce jail time or damage done to your record. You may think you are good at negotiating but let's be honest—you probably aren't.

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