What alternatives do I have if my insurance denies my claims for benefits?
October 3, 2023 | 40,00 EUR | answered by Yvonne Schmidt
Dear lawyer,
my name is Christine Schulze and I have a question regarding my insurance benefit claims. Some time ago, I was involved in an accident that resulted in a serious injury. As a result, I have filed benefit claims with my insurance company. Unfortunately, my claim has been denied, as the insurance company states that the accident is not covered under the agreed benefits.
This denial is causing me great concern, as I rely on these benefits to cover my medical expenses and potential loss of earnings. I am firmly convinced that the accident clearly falls under the benefits of my insurance policy and would like to know what alternatives I have now.
Can I appeal against the decision of the insurance company? Are there legal steps I can take to enforce my claims? What options do I have to challenge the denial and receive my benefit claims?
I would be very grateful if you could help me in this difficult situation and show me possible solutions. I am willing to take all necessary steps to defend my claims and hope for your expert support.
Yours sincerely,
Christine Schulze
Dear Mrs. Schulze,
I understand your concerns and fears regarding the rejection of your insurance claims by your insurer and would like to help you by suggesting possible solutions.
First and foremost, it is important for you to know that you can appeal the decision of your insurer. To do so, you should first contact the insurance company and inquire about the specific reasons for the rejection. Often, it may be due to missing documents or unclear wording in the application materials that lead to a rejection. Therefore, it is important to have all relevant documents and information ready to support your claim.
If the appeal with the insurance company is not successful, you have the option to take legal action to enforce your claims. In this case, it would be advisable to consult with a lawyer specializing in insurance law, who is familiar with the subject matter and can represent you professionally. Together with your lawyer, you can determine whether it is advisable to file a lawsuit against the insurance company to enforce your claims in court.
Furthermore, you can contact the relevant consumer advice center or the ombudsman for insurance, who acts as an independent mediation body and tries to reach an out-of-court settlement between the insurer and the policyholder.
In any case, it is important not to give up and to explore all options to receive your benefits. With the support of an experienced lawyer specializing in insurance law, your chances of successfully enforcing your claims are good.
I hope that this information helps you and I am available for further questions. Together, we will find a solution to your problem.
Sincerely,
Yvonne Schmidt
Insurance Lawyer
