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When Should You Hire A lawyer For An Insurance Claim?


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Andrew November’s Cleveland home had already been wet and seriously damaged by the time he heard the sound of rushing water.

“Our master bathroom on the top level of our house flooded,” he says. “As a result of the vertical flooding, there was considerable damage.”

But his difficulties had only just begun. After that, he had to fight with an uncaring claims adjuster from out of state for weeks, only having half of his flood damage insurance claim granted. Was it necessary for him to employ a lawyer after his claim was denied?

“We didn’t get along with the adjuster right away,” he adds. “We were treated with tales from his 30 years of expertise with every word about our loss.”

His contractor submitted a detailed estimate, but the insurance company only authorized half of it six weeks later.

“We were furious at this point,” he adds.

That’s when he and his wife decided to hire an attorney. November had it easy because he is a lawyer. November requested that the adjuster be replaced, which the insurance company did. November’s new adjuster, a fellow Clevelander, recognized the scope of the damage to his property and assisted him in getting the entire claim accepted.

It isn’t always that simple. November, who works for the Cleveland law firm Liner Legal, is familiar with the ins and outs of insurance. Not everyone is as fortunate. According to the Insurance Information Institute, around one out of every 50 insured houses has a property loss claim due to water damage or freezing each year. Every year, around one out of every 20 insured households gets a claim.

When should you seek legal advice? How can you know if an attorney can assist you? Is it true that employing a lawyer improves your chances of success? Is it also cost-effective?

When to Contact a Lawyer About an Insurance Claim

Should you speak with an attorney about your insurance claim? Small, routine claims frequently settle without a hitch. However, when there’s more at stake—for both you and the insurance company—a there’s greater risk of a disagreement. This might involve the following:
Expensive or difficult claims on which you and the insurance adjuster do not reach an early agreement
Large claims, such as fire damage, substantial water damage, or tornado damage
Claims in which it is difficult to determine who is at blame
If you have one of these claims, you’ll almost certainly require legal assistance. “It’s always best to contact a lawyer before speaking with any insurance person,” says Allen Patatanyan, co-founder of Los Angeles-based West Coast Trial Lawyers. “Consulting with a lawyer for a prospective insurance claim should be free, so there’s no reason not to get some good legal counsel before proceeding.”
He adds that consulting with an expert lawyer before contacting your insurance company to file a claim will assist you avoid damaging your case when communicating with knowledgeable insurance staff while filing a claim.
“Keep this in mind,” he says. “It’s all about making money for insurance companies, therefore they’ll find any reason or excuse to deny your claim and avoid paying you insurance benefits.” And it all starts with your first call to file a claim.”
Others argue that you should only hire a lawyer if your claim is difficult and worth a lot of money.
“It is sometimes preferable to engage an attorney if your claim is not easy and may entail policy interpretation,” says Pamella Seay, a justice studies professor at Florida Gulf Coast University. “While some attorneys may offer you with a review to provide you with some suggestions on what to do on your own, the majority will not. In the event that the
If the sum is considerable, hiring an attorney for a review and a letter would be a good idea. Otherwise, the expense of an attorney may exceed the value of the claim.” (A lawyer letter is a demand letter from an attorney that might lead to legal action.)
To a point, even the insurance business advises a lawyer.
The Insurance Information Institute, a trade group financed by the insurance industry, released a comment on the claims procedure. “Consult an attorney,” says one troubleshooting recommendation for complex claims, however the American Bar Association quickly adds that “many legal disputes may be addressed by consumers on their own, without a professional.”
Hiring a public insurance adjuster is another effective method for a huge claim. For instance, following major house damage, a public adjuster may assist you in completing paperwork, meeting deadlines, and advocating on your behalf.

Can a Lawyer Help After Your Insurance Claim is Denied?

According to Brian Page, an associate attorney at Stewart J. Guss, a legal company specialized in injury incidents, if you have to ask that question, it’s probably too late.
“Unless fresh information is offered,” he adds, if an insurance company declines your claim, it’s doubtful they’ll alter their minds. “This is why I always advise hiring an attorney ahead of time so that you have the best possibility of getting the claim authorized right away.”
However, if your claim has already been refused, an attorney can assist you. An expert lawyer can look at the claim from all angles and determine whether there is a prospect of convincing the insurance company to change its mind.
“Because an unrepresented claimant has no opportunity to seek a remedy in court, insurance firms are not hesitant to refuse a claim based on poor grounds.” When an attorney is engaged, insurance companies are significantly less likely to try to deny a genuine claim,” he adds.
It’s not as simple as filling out a few paperwork or sending a lawyer letter to the insurance company to appeal a refusal.
“The process frequently entails the exchange of material, known as discovery, legal filing deadlines, settlement discussions, and, very potentially, a lawsuit,” says Stephen Riebling of Riebling & Payton, a criminal defense law practice in New York state.

Does Hiring a Lawyer Boost Your Chances of Success?

“Hiring a lawyer increases your chances of winning significantly,” says Sally Morin, a personal injury attorney in California.
Why? An skilled attorney will ask you a series of questions to assess your claim and determine if it is worth pursuing. If you have a case, a lawyer will utilize their knowledge to help you advance your claim.
“With folks who aren’t represented by attorneys, insurance companies deploy a few of strategies,” she continues. “If they know there’s a legitimate claim, they’ll make a lowball offer in the hopes that you’ll accept the money and flee.” If they realize it would take some effort to verify your allegation, they will just reject it and hope you will simply go away. And, to be honest, a lot of people will leave. That’s how insurance companies make their money.”
That is why hiring an attorney can help you increase your chances.
Lawyers are sometimes required to overcome the insurance industry’s methods in dealing with claims, according to Ryan Babcock, an attorney with the Babcock Litigation Company, a personal injury law firm in Georgia.
“Rather of adjusting real claims equitably and immediately, as they should,” he continues, “they refuse, delay, and divert legitimate claims by average people.” “Many matters are too intricate to manage on your own, and hiring an attorney is the best way to deal with the issue.”

Is a Lawyer Worth It?

Attorneys will sometimes take an insurance claim case on a contingency basis. You don’t have to pay until the lawyer wins your case. If the case is settled before a lawsuit is filed, standard attorney’s fees are normally 33% of the collected amount, and 40% if the lawsuit is filed. For a lesser case, a lawyer letter might be enough to submit a successful claim or appeal for as little as a few hundred dollars.
Tina Willis, a personal injury lawyer in Orlando, Florida, thinks calculating an attorney’s worth is a straightforward math problem. Insurance companies frequently agree to settle a claim without specifying the amount of the payment. And that, in many cases, is the million-dollar issue.
. “Because they may accept culpability while only paying $10,000 on a claim for hundreds of thousands of dollars, or even a few million in extreme situations,” she explains. “Insurance adjusters are well-trained to utilize methods to reduce claim value while making payments. Asking innocent-sounding queries to acquire information that eventually harms the person’s case, or dismissing the claim before all medical expenses, necessary medical care, lost income, or pain and suffering are known.”
The single most essential choice, according to November, the attorney who handled the water damage claim, isn’t whether to engage an attorney—but when to do so before it’s too late.
“Hire an attorney before the insurance company issues a final judgment,” he advises. “That’s because the sole option for review beyond the obligatory appeal procedure is to file a lawsuit in federal court.”
Federal court review is confined to the claim file established through the administrative appeal procedure, unless an exemption applies. You won’t be able to add any new evidence as a result.
So, if your claim is refused, should you employ a lawyer? No, you should employ one before your claim is dismissed, and especially before you submit an appeal. A lawyer will take a large percentage of your settlement or judgment. However, obtaining anything is preferable than getting nothing.

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