Insurance Claim Denials
Nowadays, we try to insure everything from our mobile phone to vehicle to house due the fear of uncertainty.
When the uncertain event occurs, it is but natural to claim damages. However, an overwhelmingly large amount of claims are denied or partially paid. Most common reasons stated are lack of proper documentation, delayed reporting, improper survey reports and inadequate insurance coverage.
While most of these denials hold ground, there are cases where there seems to be genuine assessment irregularities on the insurance company’s end or that a claimant tries to wrongly claim losses. That’s where we come in!
Available options
Such denials can be litigated in both civil court and the consumer forum.
Under the Consumer Protection Act, denial of insurance claim comes under the heading of “deficiency of service” and claimants can approach the appropriate consumer disputes redressal commission to seek damages and compensation.
We, at Magnus Legal Services LLP, have successfully represented individual clients whose insurance claims have been rejected on the grounds of suppression of material facts, delay in giving intimation to the insurance company, supply of wrong information in the Application Form, improper disclosures etc. before the appropriate forums.
At the same time, we at Magnus Legal have successfully defended insurance companies against suits arising from various claim denials.
Some cases we have worked on:
– Overturned an insurance denial based on an improper survey conducted by the insurance company by representing before the National Commission;
– Successfully represented an insurance company before the National Commission, by getting a stay on the order of the State Commission, on the grounds that there was delay in intimating the authorities and that the consumer’s claim was time-barred.
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