What to do when your insurance won’t pay up
It’s hard to imagine your insurance company leaving you out in the cold. Especially in Colorado, where it can be really cold.
Sometimes there are very legitimate reasons for an insurance company to deny you, but sometimes – alas – there are not. There are times when an insurer will unreasonably deny your request for coverage, and it will be up to you to unearth that legitimate claim.
Duties to the insured
In Colorado, like everywhere else in the United States, an insurance company has a duty to its insured. There is a binding contract between the two parties, and just like you have the obligation to pay premiums every month by a certain date, the insurance company has a duty to spring into action in the event you call upon them.
The Colorado Revised Statutes make it very clear that insurers’ denials must be reasonable. That is the key word here: reasonable. Additionally, they must not act with reckless disregard in their investigation of an insured’s claim.
Listed below are just a few types of unreasonable actions an insurer can take:
- Failing to promptly communicate with an insured;
- Not investigating a claim quickly enough after being informed of it;
- Refusing to pay a claim without a reasonable investigation;
- Forcing insureds to start litigation by offering an amount far below the policy limits;
- Failing to settle claims in which fault is reasonably clear; or
- Not offering reasonable explanations as to denial.
Any of these reasons would be enough for an insured to seek out an attorney, but the first stop should be to speak with the insurance adjuster’s supervisor in an effort to keep everyone’s costs down. If appealing to reason doesn’t work, notify the Division of Insurance. The insurance company needs to remember that it has a duty under the revised statutes not only to investigate a client’s claim, but also to weigh the client’s interests as equal to its own. If all of that doesn’t work, then hire an attorney.
According to both Colorado case law and statutory law, an insurer cannot deny a claim without substantial justification; they shouldn’t “low-ball” their clients with insulting numbers that don’t coincide with their coverage; and they need to provide actual reasons for any denial of a claim.
If you need to hire an attorney to pursue your insurance company, speak with an Enjuris Colorado law firm partner!
Has something like this happened to you or someone you know? Tell your story below!
Jeannette Apolinar says
My mother was traveling from Dallas to Modesto, CA on 4/10/2021. She had to stop and switch planes in Denver. She was traveling with her 19 year old grandaughter who has Autism and has an intellectual disability. My mother doesn’t speak English well and doesn’t read or write. They could not find the elevator when they were looking for the gate to board their flight from Denver to San Jose. They ended up getting on the escalator. As they were going up my mother said she felt a sudden shake or bump and it made her lose her balance and fall on the escalator. She nor the grandaughter knew to request an incident report and if they had known they wouldn’t have known how or what. They went on an boarded the plane. My mother hit her head, knees and side. I called the airport to report it and filed a claim online. I requested footage and I was told they could not locate any that shows her falling. I was left message today that her claim is being denied because they don’t see her falling but she did fall.