8 Reasons You Might Need An Attorney For Insurance Claims

Last updated on: November 14, 2022

There are many kinds of insurance policies that cover a wide range of losses or damage. These claims may include automobile, homeowner’s, business, and health insurance policies. At Zinda Law Group, we can help you with almost any insurance claim you may have.

When making an insurance claim, you may be wondering whether you need an attorney. Insurance companies look for reasons not to give you the maximum amount of compensation for your injuries or property damage. In some cases, insurance claims are denied altogether. At Zinda Law Group we look to make the negotiation process less stressful and help victims seek compensation.  

1. Unexpected Termination

An involuntary loss of insurance can cause you to pay your medical bills out-of-pocket. There are a number of events that can lead to an unexpected termination from your insurance company. Sometimes, if you lose coverage, there is an opportunity for special enrollment.

If you’re subject to an unexpected termination, one of your options is to file a personal injury lawsuit. The attorney can work as a conduit regarding ongoing negotiations with the insurance company. Additionally, you may be able to collect damages from the insurance company in the same or a separate suit if your termination was wrongful.

2. The insurance company denied your claim

You have the right to appeal the decision and have it reviewed by a third party if your healthcare provider denies a claim or terminates your coverage. After the denial, you can request that your insurance provider reevaluate its choice. In most cases, the insurance company must explain their decisions to deny your claim or to terminate your coverage.

There are several reasons why an insurance company will deny a claim. A claim may be denied if it involves a preexisting injury or property that was not covered under the insurance policy.

3. Payout Refused for fraudulent reasons

Insurance fraud is frequently committed for monetary benefit. When a customer files a claim with the intent to deceive their insurance provider or the overall claims process, insurance fraud has occurred. There is good reason for an insurance company to deny suspicious claims, but when an adjuster makes a mistake there’s legal recourse.

Employees of insurance companies are responsible for deciding whether or not to approve the claims that they receive each day. Sometimes valid claims are rejected or marked as possibly fraudulent due to the number of claims they must process. 

4. Delayed payments

When you pay an insurance premium, that money is invested to produce income. Once an insurance company is required to pay a claim, the money set aside to cover the claim continues to earn interest or a return on investment until the policyholder or the contractors hired to do the repairs receive the check.

The insurance company is there to offer accident protection. However, they are a business like any other and they want to increase their profits. One way of increasing their profits is to reduce payouts for insurance claims. An experienced attorney may be able to investigate your claim, discover evidence of bad faith, and prove that your claim was unfairly treated, despite its validity.

5. When Fault Is Hard to Establish

Your claim needs to be backed by evidence to be awarded compensation in any type of automobile accident lawsuit. The insurance company will need reliable evidence demonstrating that the accident was caused by the driver and that you were not at fault.

The evidence collection process involves several steps, one of which is gathering evidence to show fault, which is frequently more difficult than it seems. The types of evidence that need to be gathered include:

  • Police reports
  • Pictures of the scene
  • Pictures of injuries
  • Pictures of the vehicle
  • Driver information
  • Witness contact info

Most people don’t know what kind of evidence is used to support a legal claim. Immediately following the accident, think of what evidence will be needed to support your accident claim. If it is not too late, it’s always good to capture the state of events, whether in writing, pictures, or video as the events are unfolding or immediately thereafter.

6. When You Have a Complex Claim

A simple claim usually involves minor auto damage, no property damage, and no bodily harm. Simple insurance claims include, for instance, a bumper-to-bumper collision at low speed. These types of claims are frequently able to be resolved over the phone or by email because they typically don’t involve a third party.

Significant damage to your car, another vehicle, property, or bodily injury can make a claim significantly more difficult to handle. When a claims adjuster has to account for more facts it’s more difficult to determine the amount of the damages.

7. When you have a large claim such as catastrophic injuries

A catastrophic injury is viewed as extreme or exceptionally serious, and significantly impacts a person, often necessitating significant medical care. Although catastrophic wounds may not necessarily be irreversible, they may take months or even years to heal.

The at-fault party’s insurance companies will make every effort to limit their liabilities, even if the accident is catastrophic. Unfortunately, if insurers are successful, the victim might only receive a little payout that does not even come close to paying for all the damages. A competent attorney will assess the full value of your case and fight for the highest amount of compensation possible.

8. When you and the insurance adjuster don’t agree on a claim early on

It’s stressful to initiate an insurance claim with an insurance provider. You can feel angry and concerned when you learn that the adjuster for the insurance company wants to give you less than you had anticipated.

Insurance providers must compensate qualified applicants fairly. What is fair depends on the facts of your case, however, claims are often undervalued. Be aware that you can always contact a knowledgeable insurance attorney to help with understanding the different elements of your claim.

Can a lawyer help if your insurance claim is denied?

A bad-faith insurance attorney can protect your interests. If you’ve considered suing your insurance company for rejecting your claim or engaging in other wrongdoing, contact a bad-faith insurance attorney today.

You already had to deal with the circumstances that led to the insurance claim, let alone the hassle of a difficult insurer. Additionally, you can be sure that the insurance company will be prepared with a team of skilled attorneys working tirelessly to defend their clients. Contact an insurance lawyer right now to level the playing field.

Should I get a lawyer before talking to insurance?

Zinda Law Group attorneys may be able to assist you with your insurance claim. We have helped countless clients pursue the compensation they are entitled to, even when their insurance companies are refusing to provide payment. We can negotiate on your behalf, improve your chance of receiving compensation, and fight for you in court if a favorable settlement cannot be made.


The victim of an accident should never wrongfully be denied compensation. If you’ve had an insurance claim denied and have yet to be paid for your injuries, contact the bad faith insurance attorneys from Zinda Law Group at (800) 863-5312. 

In addition to offering 100% free consultations, we also offer a ‘No Win, No Fee’ guarantee.