The reality is that many insurance claims are initially denied by insurance companies.
Policyholders faced with an insurer that refuses to cover an insured’s claim or to pay the full value of the claim might have the right to pursue a lawsuit for insurance bad faith or breach of contract. However, you might have other options because the policy may have an appraisal clause or mediation clause. These remedies are both forms of alternate dispute resolution (ADR). These approaches are not interchangeable.
An appraisal clause will be contained within your policy. The provision essentially will provide that if you have a dispute with your insurance company about the value of your loss, and either you or the insurance company invoke appraisal, then each side will select an appraiser. These appraisers will agree on a neutral umpire who will determine the amount of the loss. The decision of the umpire joined by one of the appraisers will be binding on both parties. Although the appraisal process might not result in a perfect resolution of your insurance claim, the process is typically promoted as a prompt resolution.
The mediation process involves both the insurance company and policyholder collaborating to pick a mediator to facilitate an agreement. Unlike the appraisal process, mediation does not involve the mediator imposing a decision. The mediator’s role is only to assist the sides in reaching a mutually acceptable resolution.
You can reach Miami Insurance Claims Lawyer J.P. Gonzalez-Sirgo by dialing his direct number at (786) 272-5841, calling the main office at (305) 461-1095, or Toll Free at 1 (866) 71-CLAIM or email Attorney Gonzalez-Sirgo directly at [email protected].