How do I deal with an insurance company that won't pay?

Asked by: Rosalinda Ortiz  |  Last update: August 31, 2025
Score: 4.2/5 (19 votes)

If your health insurer refuses to pay a claim or ends your coverage, you have the right to appeal the company's decision and have it reviewed by a third party. You can ask that your insurance company reconsider its decision. Insurers have to tell you why they've denied your claim or ended your coverage.

What is it called when an insurance company refuses to pay?

If you have submitted a valid claim to your insurance company, and it is refusing to pay or settle your claim, the insurance company may be acting in bad faith.

How do I get an insurance company to pay?

When Your Insurance Company Won't Pay: 12 Tips
  1. Don't assume that the first “no” you receive is final. ...
  2. Insist on a written explanation. ...
  3. Read your policy carefully to determine if the claim was legitimately denied. ...
  4. Do not accept filing errors as ground for refusal. ...
  5. Do your own research to support your claim.

What to do when an insurance company ignores you?

You should try to contact the supervisor of the adjuster (if there is one). If not, you can report the company to your state's insurance commission. You may also want to consult with a personal injury lawyer (if you were injured).

What happens if another insurance company won't pay?

Prepare for Litigation. If other avenues don't lead to a satisfactory resolution, your lawyer may recommend filing a lawsuit against the insurance company. Litigation can be a longer process, but it might be necessary to receive fair compensation for your damages.

Why insurance company won't pay your claim even though at-fault driver admitted fault to you?

29 related questions found

How do I fight back against insurance companies?

There are 2 ways to appeal a health plan decision:
  1. Internal appeal: If your claim is denied or your health insurance coverage canceled, you have the right to an internal appeal. ...
  2. External review: You have the right to take your appeal to an independent third party for review.

What happens if your insurance doesn't get paid?

Policy cancellations. After your grace period, your auto insurance company may terminate your policy. Before then, your insurer may send you a payment reminder via mail or email. If your policy ends and you don't have another policy lined up, your insurance coverage could lapse.

When should you sue an insurance company?

You may be able to sue your insurance company for bad faith if they intentionally neglect to perform the duties necessary according to your policy. If the insurance company knows that the claim is valid but they deny it anyway, you may be able to sue for bad faith.

What to do when insurance won't answer?

Contact Your Insurance Representative's Supervisor

If you have been relegated to calling your insurance company's 800 number and leaving message after message for your point of contact, only to never hear back, try someone else. Contacting a supervisor may move your claim forward quicker and without too much trouble.

Can you sue an insurance company for not responding?

Seeking Legal Advice

A lawyer specializing in insurance law can guide you through your options and help you decide on your next steps. Yes, it is possible to sue an insurance company if they are taking too long to settle a claim, as this could be considered bad faith.

How do I get my insurance company to settle?

8 Insurance Settlement Negotiation Tips
  1. Understand the Insurance Company. ...
  2. Initiate the Claim as Soon as Possible. ...
  3. Never Admit Fault for the Accident. ...
  4. Stick to the Facts, Never Speculate. ...
  5. Know the Rough Value of Your Claim. ...
  6. Be Patient, Do Not Accept the First Offer. ...
  7. Get Everything in Writing.

How do I demand payment from insurance company?

Include a Fair and Reasonable Demand Amount

One of the biggest tips we can give you is to make a demand higher than you are willing to settle for. Insurance companies rarely receive a demand and agree to pay it immediately. Instead, they will counter your demand and negotiate a smaller settlement amount.

What are subrogation rights?

“Subrogation” refers to the act of one person or party standing in the place of another person or party. It is a legal right held by most insurance carriers to pursue a third party that caused an insurance loss in order to recover the amount the insurance carrier paid the insured to cover the loss.

How do I force my insurance company to pay?

Keep in mind that insurance companies are never forced to pay any injury claim until you have a Court Order called a “Final Judgment” telling them they must pay you. Until you have that in your hand, they only pay if and when they want to. Filing suit is how you take control of your case.

Why do insurance companies never want to pay out?

Insurers maximize profit by minimizing their expenses. Paying money for insurance claims is a large expense of an insurance company. The less that is paid out, the more money for their owners (the stockholders).

What happens if insurance doesn't want to settle?

If your insurance claim does not settle, your attorney can pursue a personal injury lawsuit on your behalf in civil court. Filing a lawsuit will involve: Preparing and filing legal documents. Gathering evidence.

How do I argue against an insurance claim?

Submit a Claims Appeal Letter to the Insurance Company

This letter should explain why you believe the claim was incorrectly denied and include evidence to prove your argument. Evidence you should send with the appeals letter includes photos, videos, medical records, and witness testimony.

Can you sue an insurance company for denying coverage?

When the insurance company fails to honor your policy or refuses to compensate you for your losses, you have the right to file a lawsuit. Insurance companies are typically profit-driven, but while denying your claim may be in your provider's best interest, it's not in yours. You have damages that require compensation.

How likely is an insurance company to sue you?

While subrogation allows insurance providers to pursue third parties, an insurer usually cannot sue their policyholders. However, there are certain situations where an insurer may take legal action against its policyholder.

What is an example of negligence in insurance?

Negligence is an insurance term that is tied to various types of liability insurance, such as home, life, health, business, and auto. For example, perhaps a retail shop owner was negligent by leaving their water hose out after cleaning the sidewalk, causing a passerby to trip.

Can you sue an insurance company for not paying enough?

If you're not satisfied with the outcome of your dispute, you have the right to sue the insurance company in a court of law. You can use these resources to find legal help. You can also ask for alternative dispute resolution, which uses mediation with a neutral third party to settle disputes outside court.

What happens if an insurance company can't pay?

If an insurance company acts in bad faith to intentionally delay payment for a valid claim, there are a few things you can do. You may have options to: File a lawsuit against the insurance company. File a lawsuit against the party that caused your accident.

How often do insurance appeals work?

The statistic is particularly alarming when one considers that the overwhelming majority of appeals—83.2%—resulted in the insurance company either partially or fully overturning the initial prior authorization denial in 2022. That figure is similar to what the overturn rate was between 2019 and 2021.

Can I sue my insurance company for emotional distress?

Yes, you can sue for emotional distress under the common law standard, but it can be hard to prove. This is because you must show that the result of your claim denial caused you pain and suffering or emotional distress. This intangible loss can be more difficult to prove than, say, the cost of medical bills.