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Are Closed Insurance Claims in Florida Really Closed? – Herman & Wells

Here’s the situation: A Floridian receives a letter from his insurance provider saying his claim is closed. What actions (if any) can you take to reopen your insurance claim? Fortunately, this does not mean that you have to live with this decision. To provide more context in this type of insurance dispute, it’s helpful to break down what “closed” actually means.

please note: our law firm specializes in helping clients with insurance dispute cases in the states of florida & Georgia. If you’re visiting our site from out of state, we hope you’ll find this information helpful, but unfortunately we won’t be able to accept your case.

Reading: What happens when an insurance claim is closed

your florida insurance claim has been closed, what does that mean?

closed insurance claim

When an insurance company closes a case in Florida, the claim becomes inactive. this means that the adjuster is not taking further action. the investigation has been stopped, no further payments will be sent and the case has been closed.

It is important to note that a closed claim does not mean that the insurance company has denied the claim. it means that the insurer does not feel that it is worth continuing to work on it. They haven’t refused to pay him yet. if you do not contest this decision, the claim will be closed and you will not get the compensation to which you are entitled. however, you may still see an increase in your insurance premiums.

Please note that insurance claims are closed after an uncontested payment. The only reason you would want to reopen an insurance claim in Florida would be if you are not satisfied with the amount or if you have incurred additional expenses since the incident occurred.

#1 reason Florida insurance companies close claims

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The most common reason an insurance claim has been closed in Florida is that they have not heard from you in a certain period of time. This means that it’s important to keep following up on a claim, so your insurance adjuster doesn’t think (and can’t pretend) that you’re no longer interested in pursuing the claim. Your claim may also be closed if you do not provide the information they request in the time period they request.

In other words, a claim is closed, rather than denied, if the insurer thinks you are no longer pursuing or serious about the claim, or if the insurer feels it has done enough about it (which which might not fit with your opinion in this case).

Insurers may also close a claim for other reasons, and in some cases may close a claim and, for example, total a vehicle without further inquiry. They don’t legally have to tell you they’re closing your claim, but reputable insurers will keep you informed. Your case may also be closed after a settlement, but you may want to reopen the claim if the settlement is insufficient, such as if you incurred more expenses after the settlement date. you may also not agree to the agreement.

what should you do if your claim has been closed?

The first thing you should do is communicate, through multiple channels, that you are still processing the claim. at least one of those channels must be in writing (email or mail) so that you have documentation that you requested to have the claim reopened. calling also absolutely ensures that your insurer gets the message. mail and email can be lost, so follow up and ask if they received it and resend if necessary.

In many cases, this will be enough for them to reopen the claim. If you have any new documentation related to the claim, such as medical records, be sure to submit that as well. If the claim was settled, you will almost certainly have to submit some kind of new information to reopen it and seek further damages. this may include medical bills for treatment received after the settlement date or repair bills for hidden damage related to the accident.

If your case was closed without payment, then you can and should pressure your insurer to reopen it. In some cases, insurers will do this to avoid a claim being denied outright, which tends to result in a quicker response and more of a fight. Letting a case close can be a way for an insurance company to try to evade payment, but it can also be legitimate because it took too long to respond to a request for information.

what if they refuse to reopen the claim?

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In some cases, your insurer may refuse to reopen the claim. in this case, she should talk to her lawyer. (You should already have an attorney; it’s best to hire one as soon as the accident or incident occurs.)

You can sue your insurer to reopen a claim if you haven’t been paid (and yes, you can sue if they deny the claim) or if you’re not happy with the settlement you received. think carefully before suing your insurer if you have already received a settlement; you may end up with more trouble than it’s worth and possibly no increase in pay. Your attorney can advise you if it’s worth pursuing the claim.

You can and should sue if you believe your insurance company has acted in bad faith, such as failing to pay a claim where liability seems reasonably clear. you can also sue your insurance company for accepting a claim and not approving or denying it within a reasonable time; this may well be a course of action to take if they have closed a claim without payment and refuse to reopen it, perhaps arguing that there is not enough information.

It’s also possible to sue if they deny a claim and don’t tell you why; This is also a tactic you can take when an insurer refuses to reopen a claim. In these cases, you are most likely suing for breach of contract. Most insurance companies will settle the claim rather than take you to court, so often the threat of a lawsuit is enough, but you must be prepared to comply. do not try to handle your own legal matters. you need expert help to get through the process in a timely and reasonable manner.

how to increase your chances of reopening your insurance claim

There are a few things you can do to increase the chances of your claim being reopened. These are some of them:

  • provide any new evidence you have. keep everything related to your claim and don’t be afraid to continue submitting new items and documentation while the claim is being adjusted. be honest and don’t try to discuss expenses that didn’t exist. you may also need to send them new copies of the original documentation.
  • If you haven’t heard from your insurer in a while, follow up. Above all, be sure to ask them if they received any recently requested information. missing documentation can easily be mistaken for not bothering to send it.
  • Document all your correspondence with your insurer. In general, you should assume that phone calls are being recorded. take notes during those phone conversations and always include who you were talking to. In some cases, problems with a claim can arise when people at your insurance company don’t communicate. in other cases, your insurance company may claim that you did not follow their protocols.
  • Discuss expenses incurred after settlement. This is often the case with personal injury cases, where delayed damages may be discovered months later.
  • Do not sign any type of release or waiver unless you are completely satisfied with the payment or settlement received. Once you have signed a release, it can be almost impossible to reopen the claim. You may need to sign the form before you get paid, but again, don’t do this unless you’re happy with the settlement amount. insurance companies will often put a lot of pressure on you to sign these forms quickly. Also, do not sign if you are still receiving medical treatment.
  • Follow your insurance company’s protocols to the letter when it comes to documenting and filing your claim. They will use any mistakes as an excuse not to reopen the claim.
  • Hire an attorney specializing in insurance law. while it’s best not to be too intimidating, you shouldn’t try to fight this on your own. In many cases, insurers will be more willing to play ball when a lawyer’s name is on the letter, as they don’t want to end up going to court and paying the related expenses. Always remember that while insurance companies don’t like paying claims, they like court time even less.
  • You may not be able to reopen your claim if the legal limitations have expired or if your policy has since been renewed, so be sure to make your request to reopen your claim immediately, as soon as you receive the closure letter. that.

    It may seem like a closed case is a final decision and, in fact, insurance companies often expect the claimant to walk away after receiving it. however, it is usually possible to reopen your case, and sometimes a simple request is enough. When it doesn’t, Herman Wells can help. Contact us for a free legal consultation and to find out how we can help you reopen your insurance claim and get the compensation and damages you need and deserve.

    See also: HMO vs PPO: Differences, Similarities & Things to Consider | CareFirst BlueCross BlueShield

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