What Exactly is an Insurance Dispute?

medical claim denied | what exactly is an insurance dispute?Insurance policies are usually purchased to protect against financial losses due to illness, injury, disability, and death.  Insurance can also provide liability protection if the insured causes bodily harm to someone else, or damages another person’s property in a car accident or other type of accident.  

However, the technical language used in most insurance policies can be difficult for most policyholders to interpret.  Insurance companies may try to use this to their advantage by denying valid claims based on minor technicalities.  However, insurance laws are in place to protect the rights of insurance policyholders.  If your insurance company has denied a valid claim or treated you unjustly, you should consult a qualified insurance dispute attorney for information about your legal rights, and to learn what your options are.

An Insurance Policy is a Contract  

An insurance policy is a contract between the insured person or policyholder and the insurance company.  It is therefore, a legally binding agreement and both parties are obligated to uphold their end of the agreement.  

The basic obligations of the insured include honesty on the insurance application and paying insurance premiums on time.  The insured is also expected to submit claims in a timely manner and to cooperate with the insurance company during the claims investigation.  In turn, the insurance company is obligated to provide the benefits stated in the insurance policy when the insured submits an insurance claim.

Problems arise when insurance companies use stall tactics to delay benefit payouts, offer lower settlements than what is reasonable, or flat out deny legitimate insurance claims.  In addition, the insured may be harmed if his or her insurance company fails to defend or settle a liability claim submitted by a third party, including an auto accident in which someone else sustains a personal injury.

The Colorado Division of Insurance

The Colorado Division of Insurance regulates insurance companies doing business in Colorado.  However, group employer or self-funded ERISA health plans are not subject to state laws, because they are federally regulated.  Colorado insurance laws exist to protect the insured from fraud, unfair treatment, and dishonest practices by insurance companies.  Insurance companies have a duty to act in good faith toward their customers.  When they fail to do so, they may be penalized.

Colorado state law is on your side as an insurance consumer, but you may need legal assistance to negotiate your insurance dispute or file an insurance bad faith claim.  If your insurance company has failed to investigate, settle, or payout on a personal injury claim, you may be entitled to legal recourse.  A Colorado insurance bad faith attorney will work to protect you from being victimized by the unfair or dishonest practices of your insurance company.

Contact Pueblo Insurance Dispute Attorneys at Smith & Smith 

Pueblo Personal Injury Attorney Mickey W. SmithIf you have been injured in an accident and your insurance company is unfairly denying your medical claims, it is important to know that the Colorado law is on your side. A dedicated personal injury lawyer will fight to get you the compensation you need to fully recover after a traumatic accident.

Call Pueblo attorneys Smith & Smith today for a free consultation at (719) 544-0062. Smith & Smith serves clients in Pueblo, Pueblo West, Penrose, Florence, Salt Creek, Avondale, Boone, Canon City, Colorado City, Swallows, and Fort Carson, Colorado.