Faulty Policy Interpretations 

Turning The Insurance Dispute To Your Favor

Too frequently insurance disputes stem from flawed, faulty, or unfair policy interpretations.  This is not to say that all insurance companies engage in these practices with an intent to devalue or deny valid insurance claim settlements.  Nonetheless, whether these interpretations are based on intent or on incompetence, the results can be potentially devastating to an unsuspecting or ill informed claimant.

When you invest in insurance, you are entering into a contract with your insurance company.  This contract, or policy, defines the terms and conditions of your insurance coverage.

The policy is prepared exclusively by the insurance company.  It is extremely important to understand that because the insured has no power to alter the terms and conditions of the insurance policy, the insurance company assumes the burden of defending its interpretations of the policy. 

Simply put, any questions of doubt must be answered in favor of the insured.  In legal terms, the insurance contract is considered a contract of adhesion. 

Unfortunately, most people who purchase an insurance policy do not take the time to even read their policy, much less to understand their rights under that policy.  Under these circumstances, it is inherently easy for insurance companies to exercise flawed or unfair policy interpretations, resulting in the devaluation or denial of your insurance claim settlement.
 
Regrettably, insurance companies generally take the position that their policy and coverage decisions are above question.  Your only recourse is to challenge these flawed decisions.  However, if you are completely unfamiliar with your policy and the benefits it affords, your chances for surviving the inevitable insurance dispute are limited at best.

When flawed and unfair policy interpretations are made to your disadvantage, the insurance company has in fact revised the terms of your coverage by redefining the intent of your insurance policy.  It is your job to understand the terms, conditions, and benefits of your policy.  Only with that knowledge can you expect to mount a successful challenge to your insurance dispute.
 
If you are on the receiving end of what you believe is an unfair insurance policy interpretation, you can take action.  If you believe the facts support you, consider the following claim help tips.

Do not assume that the insurance company, the adjuster, is an expert.  To the contrary, you need to become the expert. 

• Rule 1#: study and understand your insurance policy.  The insurance company assumes that you do not understand it.

• Your understanding defines your power and, in essence, forces them into a position where they must adhere to the terms of your policy.

• Armed with your knowledge, be assertive in working towards a successful conclusion of both your insurance dispute and your insurance claim settlement.

• Be persistent in your demands to effect a satisfactory conclusion to your claim.  Remember, the insurance company must be prepared to defend their policy interpretations, especially in the event of a claim denied.  Make sure they know you understand that.