Breach of Contract – Insurance Contract Disputes

A legal contract can be interpreted in a number of different ways. Because of this, it is imperative that business owners are certain that the legal language contained within that contract is properly chosen.

This is still not a guarantee that a business will be able to completely avoid a contract dispute.

One type of contract dispute which requires a great amount of care and caution is that between a business and an insurance company. Insurance companies have the funds necessary to hire experienced attorneys who are experts in getting claims dismissed.

But here is the good news: the insurance industry is one which is highly regulated. State laws dictate what insurance can and cannot do, and our very experienced attorneys at Rick Dane Moore & Associates Law Firm, P.L.L.C. have made fighting contacts with insurance companies one of our legal specialties.

What to Do When Entering a Contract Dispute with Your Insurance Company

Once an insurance company denies your claim, revisit your contract. Highlight any key areas where you believe your entitlements are listed and begin to investigate your rights.

This is one way that having a consultation with an attorney who is familiar and well-versed in insurance contract disputes will help. During your initial consultation, your attorney will listen and make notes about your case, review the contract, and advise you of how best to proceed. He or she will also be able to advise you of your rights, such as:

  • The insurance company is not allowed to misrepresent your policy. The company cannot purposely mislead you or tell you that your policy means something that it doesn’t mean
  • The insurance company cannot withhold payment on a “valid” part of your claim while disputing another
  • Claims must be acknowledged and promptly processed

Speak with Your Insurance Agent

Your insurance agent is another valuable resource to call upon when trying to resolve a disagreement with your insurance company amicably. The agent may be able to resolve the issue over the phone from his or her office.

If you do not have an insurance agent or broker, then you may want to discuss the issue with a customer care agent from the insurance company.

Send a Letter to the Manager

When speaking to the customer care agent, try to obtain the name of the manager before you write the letter. In the letter you should:

  • Clearly state the issue at hand
  • State what you believe is a fair resolution based on your contract
  • Include information about phone conversations with customer care agents (dates of calls, names of people spoken to, etc.)
  • Write down your policy number and daytime phone number
  • Attach copies of bills, written correspondence, canceled checks and/or bank statements

An experienced attorney will be able to draft the letter for you and have you review it prior to sending. This can fast track a resolution and help you avoid lengthy litigation or court proceedings.

Seek Third Party Assistance

A well-written letter can resolve the issue, but if the insurance company is still pushing back, you have other options.

  • Call your state’s insurance department
  • Call the consumer protection division for your state (if applicable)
  • Call the Better Business Bureau
  • Enter into mediation/arbitration

Take Legal Action

If you are still being denied by the insurance company, you do have the option to take them to court. The real benefit of this action is that insurance companies rarely want to enter into a lengthy and expensive litigation. Because of this, they may decide to settle the dispute quickly. This is one of the reasons why when our lawyers at Rick Dane Moore & Associates Law Firm, P.L.L.C. call insurance companies, the dispute may be quickly settled outside of court and without our clients ever needing to enter the courtroom.

The key to a quick settlement is choosing an attorney who is fit for the task at hand. Our law firm has experience and expertise in:

  • Life insurance
  • Casualty insurance
  • Liability insurance
  • Annuities
  • ERISA
  • Health insurance
  • Auto insurance
  • Health insurance
  • Business insurance

After being involved in the insurance sales industry for a number of years, Mr. Moore knows the cold hard facts about the insurance industry. He has the experience necessary to understand and analyze your insurance policy declarations and terms which allows him to create a convincing and easy to follow argument for the judge.

If you are facing a contract dispute with your insurance company, we invite you to call us today to schedule a consultation at (405) 366-0373.