Avoiding Pitfalls in Insurance Claims

Sam John

Share Post:

Policyholders pay good money for their insurance. But when a loss occurs or someone sues you, insurance coverage is not automatic. People who make insurance claims face several potential pitfalls that may prevent them from getting what they paid for.

One of the first mistakes policyholders sometimes make is failing to promptly notify the insurance company. Insurance policies typically require a policy holder to provide “prompt notice,” notice “as soon as possible,” or the like. It is important for policyholders to promptly notify insurance companies of potential claims because insurance companies may deny coverage based on a policyholder’s delay.

Sometimes policyholders are convinced not to pursue a claim after speaking with an insurance adjuster who tells them that their claim is not covered. It is important to realize that people who work for insurance do not have the policyholders’ best interests at heart. They may seem friendly and helpful, but their job is to do everything they can to avoid paying the claim. They can oversimplify the coverage issues, make misleading statements, and even misrepresent what is covered. Instead of relying on an informal phone conversation with someone who works for the insurance company, policyholders should submit a formal claim and get the insurance company’s acknowledgment of the claim and the coverage decision in writing.

Another mistake that can occur is blind reliance on an insurance company’s coverage decision. Often, there are complicated facts and complex coverage issues. For example, property damage may have been caused by several factors, some of which are covered and some of which are not. Or you may be sued by someone presenting several claims, some of which are covered and some of which are not. If you receive a reservation of rights letter or you believe that a coverage decision may be incorrect, an experienced insurance coverage attorney can review your insurance policy and ensure that you get what you paid for.

Of course, filing an insurance claim can lead to an increase in the premium that policyholders pay for future coverage. Even before you file a claim, an experienced insurance coverage attorney can help you determine what is covered, whether to file the claim, and how to navigate the insurance claim process.

At Milgrom Daskam & Ellis, we have a team of skilled attorneys who can assist you with all your insurance claim needs!

ABOUT THE AUTHOR

Sam is a partner in Milgrom and Daskam’s litigation group. Sam represents clients in a variety of business disputes. Sam has achieved successful outcomes for his clients in all phases of litigation and dispute resolution, including mediation, arbitration, trial, and on appeal. He has litigated cases involving claims for breach of contract, fraud, injunctive relief, insurance coverage, misappropriation of trade secrets, trademark infringement, construction defects, and enforcement of arbitration clauses.

More Articles

Copyright Law

Check This Contract if You Are a Human

The first returns have arrived in the battle between copyright holders and technology companies over whether AI training on artist data, or the use of AI to simulate artist styles constitute copyright infringement, and they are not encouraging for those who like their art human.

Read More »
Business & Corporate Law

Qualified Small Business Stock: 2025 Update

We’ve previously written about Qualified Small Business Stock (QSBS) and the potential tax benefits that come with it if you structure your entity appropriately. The One Big Beautiful Bill Act (OBBBA), which was signed into law on July 4, 2025, expands the tax exemption available for QSBS and now further incentivizes business owners to structure their qualifying companies in a manner that will take advantage of the new rules.

Read More »
Business & Corporate Law

Certificated vs. Uncertificated Stock: What’s the Difference and Why It Matters

When it comes to owning stock, most people think about the ups and downs of share prices – not the paperwork behind their ownership. However, how your stock is recorded can have real implications. In today’s digitized world, the distinction between certificated and uncertificated stock is more relevant than ever, especially for startups, private companies, and investors managing equity in various forms.

Read More »