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Insurance Complaints: The Right Way

Posted on: December 19, 2022

LEGALLY REVIEWED BY:
Chi Hung Nguyen
December 19, 2022

insurance complaints

Unlike most businesses, the insurance company is used to getting complaints and having claims made. It is a part of their work – some is always unhappy with the result. The insurance company does not provide its buyers a product like a retail store, it provides guarantees for payment in case if something happens, like a car accident or truck accident.

So how do insurance companies make money? Insurance companies make money by not paying out the claims of an injured claimant. Every insurance company employee knows that it hurts the insurance company’s pockets and bottom line to pay a claim. Then, to get a complaint about how they handled a claim seems like it is not worth their time.

Unlike a claim, which is what the injured claimant files with the insurance company under an active insurance policy for their bodily injuries or property damages, a complaint is against the insurance company for something the insurance company did wrong.

Complaints take up their employee’s time so that they cannot handle other matters, like managerial tasks and their other duties. Then, when they get a complaint about their services, they see it as another delay.

There are a lot of different types of complaints against the insurance company. Below are some examples:

Types of Insurance Complaints

  • Bad faith issues,
  • Not answering letters,
  • Sending out a letter that does not make sense or is too complicated,
  • Not answering or returning phone calls,
  • Ignoring people when they make a complaint,
  • An insurance adjuster that is rude,
  • Paying a claim too slowly, or
  • Not paying a claim that was made.

Get the insurance company to pay attention to your claim. Insurance company employees may think that spending time to address a complaint is not worth their time, though they may make an exception for someone who has bought their insurance for many years. But except for these situations, the insurance company may simply put off handling a complaint made against it.

There are many possible reasons. One reason the insurance company may disregard a complaint is that they have dealt with bad customers or even bad lawyers before. People who are too aggressive, angry and emotional are not their favorite to deal with, and sometimes there are questions of fraud, exaggerated charges and fees or more. The insurance company employees can lose patience in these situations, and this can affect how they handle the complaint. Like in other cases, they may also think that they will be able to ignore the complaint and it will eventually go away.

Departments within an insurance company can change on the internally, or have other corporate restructuring causing delays and confusion. They may have moved a team within the insurance company out of state, or other changes in the management or staff levels. The change could even occur every few months.

Another reason an insurance company may ignore a complaint is that the insurance company is outright having money problems itself. If the insurance company is having money problems, it may sell its liabilities and business to another insurance company which can cause a lot of delay and problems. If one insurance company merges with another, it basically combines two previously separate insurance companies into one company. This may also create issues that turn into an ignored complaint.

The insurance company also may not be handling a complaint is that it was advised by its own legal department to ignore or create delay in addressing a complaint as part of its legal strategy.

Who makes the complaint also makes a difference. For example, the managers in an insurance company tends to take complaints from their own insureds, the policyholders who bought insurance from them, more seriously. So, a complaint from their own policyholder is going to be taken more seriously than any complaints from third-party claimants, which are people who make complaints about the insurance company but did not actually buy any insurance from it.

Insured policyholders have paid the insurance company money in the past. Usually, this is an insurance premium. Insurance companies want to keep their customers happy and continuing to pay insurance premiums.

Similarly, insurance companies are sued for bad faith by their own insureds than from outside, third party claimants who are upset. Courts also tend to back this up, though each state has different laws that control depending on the facts of a particular case.

Build your case

Like your insurance claim, document everything and create a paper trail of your insurance complaint. This means that you should save copies of letters, texts and e-mails you exchange with the insurance company, take screenshots from your computer or phone, save the files in multiple locations in case something happens to the physical copies or your access to a particular e-mail address and more. Consider it evidence to build your case and avoid unclear situations.

Sometimes, insurance companies make a verbal promise or reassurance over the phone. Then, when the person making a complaint follows up, there is no proof of what was agreed to and nothing to hold the insurance company accountable. This is why it is important to follow everything up in writing. Even e-mails are date stamped and time stamped, and can help you build a timeline of what happened even if several days pass since the exchange. Remember, documentation is a two-way street. Insurance companies may record calls, save your e-mails to try to use them against you later as well.

Setting deadlines and following up

In addition to confirming everything in writing by e-mail with your insurance adjuster, set deadlines. If they want information or documents from you, ask when they need it. Ask what the insurance company’s policy is about a particular issue in writing, and set deadlines for your next communication from them. The deadline can be after a certain number of days (such as one calendar week) or a specific calendar date.

After you are done talking to the insurance adjuster, set a time frame or deadline to follow up with them later. This can ensure that you are not wasting any of your precious time waiting for them to get back to you first. Many insurance companies know that they have the resources and time to handle a claim at their own pace, unlike the average person who may be trying to handle other aspects of life like going to work, having a personal life and taking care of their friends and family.

Set the right tone

There is a time and way to use aggressive tactics. In the beginning, it can be difficult to put your emotions to the side. Usually, a person who is making the complaint has been wronged in some way and want the problem to be fixed, or at least an apology. In a perfect world, this should be a quick and easy process. But this does not always happen. Then, as a result, people get frustrated and may come in threateningly or angrily. But this can create more problems if not used strategically. Being upset from the start can cause people to become defensive, overly protective and make them want to stand in your way rather than work with you to fix the problem.

Instead, try for a professional and polite tone when you speak with insurance company representatives and in your e-mails. Sometimes, an aggressive approach is required. But negotiation is a skill that takes time and experience.

Sometimes, the right tactic is to be the person willing to do the right thing and cooperate with the insurance company employee handling your issue. If they agreed to a deadline, but then have an emergency and want to postpone the deadline a few days, and you do not risk your own rights or recovery, it may be worth cooperating and granting them extra time to get back to you or deliver on what they said they would do. Working with the insurance company on some points can help you in some cases. It is possible you may be in a similar situation in the future, and will need to call in the favor for a time extension too.

Contact an experienced personal injury lawyer 

Without experience in the insurance industry or legal experience, understanding which factors or evidence can help or hurt your case can be difficult to understand.

Are you trying to secure your financial recovery with the help of experienced attorneys? If so, we can help.

The Pusch & Nguyen Law Firm has helped countless Texans handle their insurance disputes. Our experienced trial lawyers have gone up against some of the biggest names in the insurance industry while successfully bringing home payouts for clients. Our successful reputation speaks for itself, and with offices in both Houston and San Antonio, we are well equipped to assist Texans who are in dire need of our services. Register online for a free case evaluation or call us today at 713-524-8139 (Houston) or 210-702-3000 to schedule an appointment with a member of our team.

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