The Gulf Coast may get hit with two hurricanes in three days, but could Alabama get lucky and miss the worst of the weather?  Nothing was certain as of Saturday evening, and there have been big changes to forecast tracks for Tropical Storm Marco. The National Hurricane Center made a significant shift to the east with Marco’s track on Saturday afternoon. Now, instead of coming ashore in Texas on Tuesday, Marco may make landfall on Monday in central Louisiana as a hurricane.  Marco is forecast to come close enough to necessitate tropical storm and storm surge watches for Alabama’s coastal areas. Laura’s threat to Alabama is less clear: Laura still has to cross over Hispaniola, Cuba, and the Gulf of Mexico, so its track is more uncertain and its effect on Alabama also uncertain as of Saturday.

Homeowner insurance.

Owning a home in Alabama comes with the uncertainty of property damage risk every year when hurricane season rolls around. Unfortunately, most people are required to have homeowners’ insurance as part of a mortgage agreement.  In the event that anything happens to the house, the bank needs to secure its financial interest in the insured property. This sometimes puts individuals at risk of accepting a subpar carrier that they might not otherwise make a contract with.

Disputes.

Insurance disputes arise in many ways. An insurer may not offer fair value for property damage under a homeowner’s policy. Sometimes, an insurer denies a claim supporting it by placing fault on the policyholder, stating they intentionally caused a loss. Some claims are denied by an insurance company for late premium payments. There are times when only partial benefits are approved for payment. When policy holders feel claims are denied due to dishonest dealings as a matter of company policy, they should contact legal counsel to assist. Denial of legitimate claims on a paid-up policy could be an incident of consumer fraud which is actionable in court.

Denied claim action.

If a denied claim situation cannot be settled between the parties of the contract, then legal action will be based on Alabama’s Insurance Code. Insurance policies are a contract between the insured party and the provider, so when a dispute about questions of coverage, or denial of legitimate claims comes up, the state contract laws will be the basis of case arguments. Contract law governs most of insurance dispute proceedings. Insurance companies have certain clauses in their contracts that are specific to their needs, and not always seen in general contract law.  When policyholders  understand the basics of these clauses, it may make the response to the claim denial stronger.

Reasons for Claim Denials.

  1. Company does not want to pay, perhaps bad faith contract.
  2. There was a mistake on an application.
  3. Lack of coverage, claim does not cover the damages a policyholder is seeking.
  4. The claim was not filed correctly.
  5. Policy modifications post claim filed.
  6. Misrepresentation of true damages.

Steps to Take After Denial.

Keep open lines of communication with the insurance company.  Written correspondence is best in the event a policyholder needs to show the timeline of actions and requests.

  1. Correct the paperwork or supply missing supporting documentation. If there was a mistake with thee application, or a claim was not filed correctly, contact the insurance company as this may be a simple fix to get the claim moving toward processing. (Keep copies of everything that was submitted.)
  2. Contact the Alabama Department of Insurance Consumer Services Division to file a complaint.
  3. If a policyholder cannot fix paperwork to reverse the denial, and a complaint with a finding to the Alabama Department of Insurance does not result in a reversal of the denial, then the next option is to consult an attorney about a policyholder’s legal rights and remedies.

Sources.

https://www.aldoi.gov/PDF/Consumers/ReqForAssistance.pdf

https://www.aldoi.gov/Legal/Title27.aspx

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