Insurance Claims in West Virginia

What Are Insurance Claims?

Filing an insurance claim in West Virginia can be a stressful process. Every policy is different, and insurance companies may not pay you what you deserve. In many cases, hiring an insurance claim lawyer is necessary. This page breaks down the nuances of different types of insurance claims.

What Is a Property Insurance Claim?

A homeowner’s insurance policy is an agreement to protect the home from damage under specific occurrences. When you as a policyholder suffer a loss, you should find a dedicated West Virginia property insurance lawyer. Your legal advocate works on your claim to ensure that you receive the benefits necessary to repair or rebuild your West Virginia property.

If the insurer denies coverage or delays, policyholders should consult a property insurance attorney about a bad faith claim. If your claim goes to court and you win, you can often recover your court costs, attorney fees, and coverage benefits. There is also the possibility of recovering more money depending on the state laws under which you file your claim.

What Types Of Damage Claims Apply to Property Insurance?

Specific geographic regions impact the design of insurance policies. For example, Florida property insurance policies have more provisions for hurricanes versus earthquakes. 

West Virginia residents have to deal with many types of severe weather, including hail, heavy snow, and thunderstorms. In addition, according to hippo, West Virginia has some of the highest flood risks in the country. Unfortunately, a regular homeowners policy will not cover damages from floods or mudflow. Therefore, you will need flood insurance if you are at risk for that type of damage and want to be covered.

How to File a Property Insurance Claim in West Virginia

After you suffer a loss, you must contact your insurer as soon as possible. Taking this step begins the insurance claim process and gets things moving along. You need to notify your insurance company in writing or over the phone. From there, your insurer appoints a claim representative.

What to Expect Afterwards

Settling an insurance claim is generally a two part process. First, the insurer will accept or deny the claim. If they accept the claim, they will then offer a settlement amount. Fortunately, West Virginia laws require your insurer to meet certain deadlines during this process. For example, your insurance company has 15 working days to provide you with the forms and instructions you need to document your loss. Furthermore, once they offer a settlement, they must pay within 15 days of the agreement.

In addition to preventing unreasonable delays, West Virginia also requires insurance companies to offer a fair settlement. If the insurer denies your claim, they must provide specific reasons. It is important to note that you do not have to accept a denial or an initial settlement offer. These decisions are typically open to negotiation or an internal appeals process. Furthermore, if you feel the insurer is acting unfairly, you can consider filing a complaint with the West Virginia Offices of the Insurance Commissioner.

What Is an Auto Insurance Claim?

Auto insurance claims involve requesting compensation from an auto insurer after an accident. Car accidents are incredibly stressful, especially if there are uncooperative responsible parties. However, your insurer’s job is to work on your behalf to secure compensation for repairs, injuries and other expenses.

What Do You Do After a Car Accident?

West Virginia statute requires that you immediately notify the police after most car accidents. The only exception is accidents that cause no injuries and where the total damage is less than $1,000. You will also need to file an accident report with the West Virginia Division of Motor Vehicles. This report is mandatory if there are any injuries or any damages of at least $500. Keep in mind that you still have to file this report yourself, even if the police file a report at the scene.

You will also need to report the accident to your insurance company. According to wallethub, West Virginia is a fault insurance state. This means that insurance is generally cheaper than in a no-fault state. However, it can also mean that it takes longer to get your settlement. The at-fault driver’s insurance should pay for your damages. However, if there is a dispute about fault, or multiple drivers are at fault, this can take time to determine.

Auto Claims Adjuster

Your auto insurance company will assign a claims adjuster to your claim report. Your adjuster acts as your representation in any mediation between you and all other involved parties. This insurance representative bears responsibility for investigating the claim and seeing that you receive compensation for any repairs or injuries.

Whether there are repair claims, personal injury claims, or you are dealing with someone who does not have insurance, your auto insurance adjuster should see you through the process. Your claims adjuster may recommend a garage to handle your vehicle repairs. They may also make arrangements for a rental vehicle if required. The most important thing to note is that your auto claim adjuster is your primary point of contact regarding the status of your claim in West Virginia.

Health Insurance Claims

West Virginia policyholders file health insurance claims when they seek reimbursement for medical services or treatments. When you obtain a medical service from a provider, your health insurance carrier should be notified directly. If there are any discrepancies in your claim, consider hiring a health insurance claim specialist attorney.

How Do You File a Health Claim in West Virginia?

There are two ways to file a health insurance claim on your behalf. The first is the medical facility notifies your insurer for you. You may be able to walk out of the facility without spending anything, but that depends on your policy. The other way is to file a health insurance claim yourself. Taking this route can occur when a health provider you use is not in your provider network. The facility may still file the claim on your behalf, but you may need to file it yourself.

Many healthcare claims decisions are pretty clear-cut, and your insurance policy either covers the treatment or it doesn’t. However, there are some gray areas. For example, the Charleston Gazette-Mail reports on a case currently in West Virginia federal District Court. The issue is whether the insurance company’s denial of a claim involving treatment for gender dysphoria violates discrimination laws. The judge has held that the insurance company is subject to these laws, however the case is still in court as of this writing.

Work with an Experienced Local Insurance Lawyer in West Virginia

If your health insurance provider refuses to honor a claim, seek out a qualified West Virginia insurance claim attorney’s help. An insurance claim attorney can help if you have been improperly denied coverage or sent a bill for a service you never received. We can even help you connect with an attorney across West Virginia state lines.

Submit a request online or call us today at (866) 345-6784 to get in touch with an experienced lawyer in your area!

Check out other areas of West Virginia state law that might apply to your case!

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Lemon Law

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Patent Law

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Power of Attorney

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