Has an Insurance Company denied your claim?
Many South Carolinians protect themselves and their loved ones by obtaining
occupational insurance policies which represent that they will pay for
medical costs and supplement income should you become injured. Unfortunately,
many times these insurance companies refuse to follow through on their
contractual obligations providing claimants with no compensation and no
explanation for the denial of their claim.
In South Carolina, an insurance company has a duty of good faith and fair
dealing. This duty includes an insurance company timely and fairly handling
claims as well as providing a detailed and legitimate explanation for
the denial of a claim. Failure to adequately communicate and pay claims
in a timely manner can lead to the suspension of necessary medical treatment
and can leave you in financial ruin. As a result, payment under the policy
and damages resulting from the insurance company’s refusal to pay
your claim may be recoverable.
Insurance policies, and specifically occupational insurance policies, can
be tricky to navigate and understand. It is difficult to know whether
there is coverage when there are some many endorsements, exclusions, and
exceptions to exclusions that can make your head spin. However, when the
language of the policy is ambiguous, as they often are, our courts have
construed them in favor of coverage and the claimant. Further, our courts
have held that it is bad faith on the part of an insurance company to
misrepresent to an individual there is coverage, when in fact there is none.
Many occupational insurance policies have several layers of coverage, some
of which are only triggered by the claimant’s ability to qualify
as disabled. It is bad faith on the party of an insurance company to sell
an individual a policy that they could never possibly qualify for. This
misrepresentation only provides what is known as “illusory”
coverage because in reality the policy covers little, if anything, that
Do you believe that you have had an occupational or other insurance claim
that has been wrongfully denied? If so, Finkel Law Firm LLC can advise
you of your rights and potential claims against your insurance company.
Please do not hesitate to contact us to schedule a consultation.