Insurance Claim Denial Defense

Dedicated Insurance Claim Denial Lawyers

Fort Lauderdale, Florida – Partners on Call 24/7

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insurance claim denial lawyers

You pay insurance premiums to protect yourself and your family in the unfortunate event of an accident, injury or loss outside of your control.

After paying your insurance provider for weeks, months, or even years, you have a reasonable expectation that your claim will be honored and your benefits paid.

When your insurance company denies your claim or underpays the benefit, you’ll feel angry, confused, and helpless.

The denial experience can leave you immediately unsure of how to cover your bills or commence urgently needed repairs (in the case of property coverage).

Denials happen every day.

The truth is: insurance companies claim denials happen to thousands of Americans every day.

A denial often occurs when you make a claim, and the insurance company determines they are not obligated to pay your insurance benefits for a particular reason. For example, your insurance company may allege an exclusion in your policy covers your claim.

Insurance policies are complex products that can be challenging to dissect. However, they are contracts with both parties bound by their terms.

In many cases presented to us, we discover that an insurance company has improperly denied or underpaid the claim

When your claim has been denied or underpaid, you need an experienced Insurance Denial Lawyer (First-Party Insurance Attorney) fighting aggressively for your legal rights.

Leader, Leader & Zucker, PLLC Attorneys at Law are Insurance Attorneys that can help you get the recovery you may deserve in Fort Lauderdale, Florida.

Denials happen at the worst possible time. 

An insurance claim denial lawyer scrutinizes documents, carefully piecing together a defense strategy.

Individuals often attempt to claim on their insurance policy in the days or weeks immediately after their loss. Learning that your insurance company has denied your claim can be confusing and frightening during this traumatic period of loss.

Property claims often leave you without a working bathroom or functional kitchen (depending on where the damage occurred). You have nowhere to live until the insurance company can arrange the repairs.

Even individuals who regularly pay their insurance premiums, select good coverage, and have never made a claim may face improper insurance claim denials or underpaid insurance benefits.

If you believe your insurance claim has been wrongly denied or have not been paid enough to cover your loss, you need an Insurance Dispute Attorney immediately. An experienced advocate, fighting aggressively to have your valid claim recognized by your insurance company.

Navigating Insurance Claim Denials


Navigating the labyrinth of insurance claim denials can be a daunting task. Numerous factors contribute to an insurance company’s denial, some of which may be legitimate, while others may be unjustified. Health insurers may attempt to deny a claim outright, even when coverage is rightfully due, to protect their financial interests. As a policyholder, it is essential to comprehend the language of your policy and identify when an insurance company’s denial is unjustified.

Insurance claim denials can have severe consequences, such as costly medical bills, a negative impact on your credit score, and the potential to be denied essential treatment. In these situations, it is vital to take appropriate action and hold the insurance company accountable when an insurance company denied your claim.

Common Reasons for Denial

Insurance companies may deny claims for various reasons, some of which may be valid. Common reasons for denial include policy exclusions, insufficient evidence of loss, and misrepresentation on insurance applications. When an insurance company denies a claim, it may be due to provisions in an insurance policy that specifically exclude coverage for certain types of losses or damages. Insufficient evidence of failure occurs when the insurance company lacks sufficient proof to demonstrate that the loss transpired. Misrepresentation on an insurance application involves the submission of false information or the omission of a pertinent fact.

Understanding these common reasons for denial can help policyholders ensure they have proper coverage and avoid disputes with their insurance company. Being familiar with your insurance policy and recognizing any potential exclusions or limitations that may affect your coverage is crucial. Being proactive and informed can help prevent insurance claim denials and ensure you receive the benefits you are entitled to.

Unjustified Denials

While some claim denials may be justified, it is essential to recognize when an insurance company is acting in bad faith. Bad faith insurance claims occur when insurers undervalue or deny claims without a legitimate basis. In these cases, legal recourse may be available to policyholders to assist them throughout the process. For example, a Florida health insurance denial attorney can help you navigate the complex world of health insurance denials and ensure your rights are protected.

If your insurance company does not fulfill its legal requirements when denying a claim, such as providing reasons for denial and adhering to deadlines, it may be acting in bad faith. In these situations, seeking legal assistance and holding the insurer accountable is essential. Persistence and legal action can be the key to overcoming denied claims and securing the coverage you deserve.

Auto Insurance Claim Denials 

We have successfully helped hundreds of clients with auto-related insurance company disputes. However, some areas of auto claims are more challenging to assist clients with recovery – for example, uninsured motorist coverage, which prevents attorney fees from being collected on your behalf.

Unfortunately, your car insurance (auto insurance) won’t cover you in every situation.

Taxi, Uber, or Hire Usage

Most insurance companies will cancel your policy or won’t cover you in a crash if the insurance company learns that you used your car as a taxi, Uber car, or hire vehicle (without notifying them or purchasing a policy that provides proper coverage for such use).

Commercial Usage

Non-commercial car insurance policies don’t typically cover accidents if your car is used for commercial purposes.

Even if you weren’t using your car for commercial purposes when the accident occurred, the insurance company might attempt to cancel your policy retroactively if your insurer learns that the vehicle was being used for commercial purposes.

Driving Under The Influence

Another common situation in which your insurance carrier may try to avoid coverage is if you were driving drunk, under the influence, or impaired.

Unlicensed Drivers

If you let a person who doesn’t have a license drive your car, you may have no insurance coverage when an incident occurs.

Some carriers will ask you questions about who lives with you, how many licensed drivers there are, etc. This questioning has nothing to do with your claim in most instances; instead, they are attempting to find information that conflicts with anything on your original insurance application so they can cancel your policy and deny coverage.

Generally, any fraud or misrepresentations in the application or claim process can result in denying your benefits. 

If you are told it would cost $5000.00 to fix your car from theft and resulting damage and the insurance company will only pay you $3000.00, you do not have to accept what they offer and walk away.

You have the right to go after the insurance company and seek the full amount you are owed, even if they disagree. 

If you are in any of these situations, speaking to an insurance claims denial lawyer is crucial as soon as possible.

Leader, Leader & Zucker, PLLC Attorneys at Law can closely examine your insurance policy and any accompanying denial or underpayment and determine the best strategy for you.

Bad Faith – Insurance Denials


If your insurer isn’t following through on their obligations to you based on your policy, the insurance company’s denial may be in bad faith.

Insurance companies are required to work within the law when settling with you. However, it is common for insurance companies to offer you a lower settlement than you believe you deserve. While this scenario is not necessarily in bad faith, you may wish to speak to one of our experienced Claim Denial Lawyers in Fort Lauderdale, Florida, if you feel you deserve more.

We’re experts at dealing with bad faith claims on your behalf, and we’ll take the right legal action to help you throughout every stage of your bad faith denial.

Protecting Your Rights in Health Insurance Claim Denials


Under US law, all Americans are legally required to hold a health insurance policy to assist with medical bills.

However, health insurance policyholders may not be aware that health insurance claims from legitimate medical providers are regularly denied daily.

Individuals have often been denied reimbursement by their insurance companies for costly and necessary medical treatment or prescription drugs. According to AARP, 200 million health insurance claims are denied annually. Health insurance claims can be denied due to a simple paperwork error or the insurance company claiming that a procedure is not medically necessary.

In recent years, health insurance companies have become more aggressive in denying claims, including claims from medical providers for cancer and Parkinson’s patients. Sometimes, the insurance company hopes that patients will pay the claim out of pocket to avoid the hassle of fighting for their insurance coverage.

If your health insurance claim has been denied, you should immediately ask why the claim has been denied.

In some cases, your denial may be due to a simple paperwork error that your doctor can correct. With proper assistance, many denials can be recovered without legal action. If you’re facing difficulty due to an insurance claim denial, an Insurance Lawyer can assist you in resolving the matter fast.

If your health insurance claim is denied:

  1. Don’t pay any bills.
  2. Ask for the denial reason in writing.
  3. Review your plan or speak to someone who can review your plan with you.
  4. Check to see if there were any coding mistakes or missing information.
  5. Call your doctor and make sure that all paperwork is filed properly

If your insurance claim has been denied, it is essential to know that companies sometimes use software that may result in the false denial of a claim. Insurance companies often claim that treatment isn’t medically necessary when it is essential.

Re-apply, talk to your doctor, and keep records of each dealing you have with your insurance company. If you still have difficulty, it may be wise to speak to an insurance lawyer in Fort Lauderdale, Florida, who can help you fight for your rights.

An insurance claim form rests on a desk, symbolizing the complexities of legal requirements and claim denial defenses in the insurance industry

Legal Requirements for Insurance Companies

Insurance companies have specific legal requirements they must adhere to when denying claims. In Florida, for instance, the insurance company must provide the contested portion of the claim and the specific reasons for denial within 45 days of receiving it. Additionally, if the issue is incomplete and the necessary information is supplied, the insurer must pay or deny the claim within 60 days.

Policyholders must be aware of these legal requirements and ensure their insurance company abides by them. If your insurance company does not fulfill their legal obligations, it may be time to seek legal assistance to hold them accountable and protect your rights.

 

Hurricane Insurance Denials


Why Hurricane Insurance Claims Are Often Denied or Underpaid

Hurricane-related damage can be devastating, yet many policyholders are shocked when their claims are denied or underpaid. Insurance companies may argue that the damage was pre-existing or due to poor maintenance rather than the hurricane. They may also interpret policy language to exclude certain types of damage or apply high deductibles. Sometimes, adjusters might not assess the full extent of the damage accurately, leading to underestimations. It’s crucial to understand these tactics and be prepared to challenge them.

Roof Damage from Hurricanes Hurricanes can wreak havoc on rooftops, causing leaks, shingle loss, and structural damage. At Leader, Leader & Zucker, we understand the nuances of roof damage claims, ensuring that the extent of damage is accurately represented and compensated.

Storm Damage Beyond the Wind Hurricanes bring more than just wind; they introduce torrential rains and potential flooding. Our expertise ensures that all facets of storm damage, not just the obvious ones, are covered in your hurricane insurance claim.

Wind Damage: The Primary Culprit The sheer force of hurricane winds can lead to shattered windows, fallen trees, and other wind-related damages. We at Leader, Leader & Zucker are adept at distinguishing and validating wind damages, helping you secure fair compensation.

Fire Damage in the Wake of a Hurricane Electrical outages, downed power lines, or gas leaks during hurricanes can lead to fires. We recognize the devastating impact of fire damage amidst the chaos of a hurricane, ensuring such claims are given the meticulous attention they demand.

Navigating Hurricane Insurance Claim Denials with Leader, Leader & Zucker

Mastery Over Complex Claim Processes
Hurricane insurance claims present a maze of intricate details. With our expertise, we demystify the complexities, ensuring you’re on a clear path to rightful compensation.

Advocating Against Unjust Denials
Facing an unfounded denial? Our seasoned team specializes in taking on insurance giants, compelling them to uphold their commitments and offer fair compensation.

Client-Centric Representation
At Leader, Leader & Zucker, you’re not just another case. Our client-first ethos ensures personalized attention and a dedicated partnership in pursuit of justice.

Decades of Proven Experience
Trust in our longstanding legacy of successfully handling hurricane insurance claims, offering you peace of mind in tumultuous times.

Reputation of Excellence in South Florida
With an avalanche of five-star reviews from South Florida clients, our reputation as leaders in hurricane insurance litigation is indisputable.

Comprehensive Strategy from Start to Finish
From claim assessment to courtroom representation, our holistic approach ensures that every facet of your case is expertly handled.

Commercial Property Insurance Claims: Navigating the Complexities


When it comes to commercial property insurance claims, the stakes are often high. Commercial properties represent significant investments, and any damage or loss can have far-reaching consequences, affecting revenue streams, operations, and business continuity. Navigating the claim process for commercial properties can be daunting, marked by complex policy terms, potential disputes over valuation, and, sometimes, unjust denials. With our vast experience in commercial property claims, we at Leader, Leader & Zucker are adept at challenging insurance companies, seeking rightful compensation, and minimizing business disruption. Whether you’re dealing with damages from natural disasters, vandalism, or other unforeseen events, trust us to guide you through the intricate landscape of commercial property insurance claims.

Reasons You Might Need an Insurance Claim Denial Lawyer


  • Vague Denials: Insurance companies may use ambiguous policy terms or stipulations to deny a claim without a clear reason. A legal expert can dissect and challenge these denials for transparency and fairness.
  • Inadequate Settlement Offers: It’s not uncommon for insurers to propose settlements that don’t adequately address the extent of a claimant’s losses. An attorney ensures you’re not shortchanged.
  • Complex Policy Language: Understanding insurance policy wording, which can be dense and full of legal jargon, often requires specialized knowledge. A lawyer provides clarity, ensuring policy terms are interpreted in your favor.
  • Disputed Liability or Facts: In many claims, the insurance company might dispute the facts or the responsibility of parties involved. Legal representation ensures that your side of the story is firmly presented.

Why Call Leader, Leader & Zucker for a Free Consultation on General Insurance Denials in Florida?

  • Versatility Across Insurance Types: Leader, Leader & Zucker boasts a wide range of expertise, adeptly handling denials from varied insurance types, be it auto, roof, storm, or boat-related.
  • Commitment to Fair Play: Our mission transcends winning cases; it’s about ensuring insurance companies play fair, upholding the sanctity of agreements made with policyholders.
  • Transparent Insights: Benefit from a holistic, no-obligation evaluation of your claim, arming you with the insights needed to make informed decisions.
  • Champions of Justice: With Leader, Leader & Zucker by your side, you’re partnering with a firm that’s relentless in its pursuit of justice, ensuring that every denied claim is revisited, re-evaluated, and rightfully resolved.

If you are facing difficulty getting the recovery you believe you deserve from your insurer, it may be wise to speak to an insurance attorney in Fort Lauderdale, Florida. Leader, Leader & Zucker, PLLC Attorneys at Law may be able to help you. Our qualified lawyers work closely with individuals to fight insurers who do not follow through on their responsibility to consumers.

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Michael, Thank you so much for all of our support and diligence over the past seven months. That was the most trying and difficult time of my life. Michael’s legal expertise was top notch.
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954.523.2525

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Michael, Thank you so much for all of our support and diligence over the past seven months. That was the most trying and difficult time of my life. Michael’s legal expertise was top notch.
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Michael, Thank you so much for all of our support and diligence over the past seven months. That was the most trying and difficult time of my life. Michael’s legal expertise was top notch.
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