Handling Questionable Insurance Claims
Insurance policies were formulated to take care of such eventualities. They are necessary when you have suffered a loss in terms of property and limb. When the insured incident happens, there shall be investigations to determine the cause and thus the responsible party. There have been many cases where clients and the insurance companies have disagreed on the settlement terms, due to the complexities of the claims at hand. While the client is crying foul, the insurance company will feel justified to have given such a settlement amount. In such a case, it is best to hire a comprehensive forensic services provider. Their job is to get to the cause of the incident and present their findings in a manner clear to all.
You will see many cases that could benefit from these services. They will, for instance, help to prevent instances of clients saying the insurance company acted in bad faith. There is the expectation that the clients will have lawyers, hired to show that the claim was unfairly denied, that you were not awarded as per the signed contract provisions unfairly, or any other way to show that your treatment was unfair when compared to a similar one that was reasonable.
If you do not have the case investigated properly, that will not be hard to prove. When it appears that you have unreasonably denied or delayed a claim, or failed to take the proper steps to investigate a claim, there shall be case against your company. The same shall happen if it can be argued that you interpreted the contractual wording in such a narrow manner as to come out unfair on the client’s part. It gets worse if they argue that you refused to settle a claim for a client in full as per the contract, with no adequate justification.
There are many incidences of the clients attempting to get a settlement where it is not due. They have led to severe losses for insurance companies on the past due to their numbers. They are the reason why you need to have such services around, to safeguard the interests of all concerned parties.
Each client under your policies has certain rights that need to be protected. You also have certain rights that the clients or any other party should not violate. IT is when there is a poor investigation job done that these rights will be in jeopardy. This does not mean that there are no good actors in the industry, as there are many cases that go off without such hitches. You thus need these services, to root out any remaining cases of fraudulent claims attempts.