Filing a claim against an insurance company is not always a simple task for the average citizen. Insurance companies are usually equipped with a battery of lawyers who are experts in their field, who are well-versed (and usually much better than the insured) in the terms of the policy, and therefore even before filing a claim against the insurance company, the insured is usually at a disadvantage.
It is not for nothing that insurance companies use many lawyers because when filing almost any claim against insurance companies, it faces a significant risk that could reach hundreds of thousands of shekels, and even much more (depending on the terms of the policy). Of course, no insurance company has the desire to pay you even a single shekel.
However, there is no need to panic about insurance companies. Like any other company in Israel, insurance companies are regularly sued in court, and it is easy to find many verdicts in which the insurance companies lost, and the insured ultimately received significant financial compensation.
Possible difficulties before filing a claim against an insurance company
לפני שרצים להגיש תביעה נגד חברות ביטוח צריכים, כמו תמיד, לעשות "שיעורי בית". חשוב להכיר את החולשות בטענות שלכם לפני שמגישים Financial claim to the court. If you are not aware of your weaknesses in advance, and discover them for the first time after the Defense On behalf of the insurance company, it will be much more difficult to win the claim. You may even have to file Request to amend a statement of claim, and this may cost you quite a bit of money (in the form of legal expenses in favor of the insurance company), and also, this may lead to a significant delay in resolving a claim against an insurance company.
These are common cases that may pose a difficulty before filing a claim against an insurance company.
- Obsolescence – Usually, the statute of limitations refers to a period of seven years from the date the cause of action was discovered. For example: You had a cause of action against an insurance company but for one reason or another you did not sue it. After eight years you filed the claim. In such a case, the court may order Dismissal of the claim outright. סעיף 31 לחוק חוזה הביטוח, תשמ"א – 1981 קובע מקרים בהם תקופת ההתיישנות קצרה יותר שנעה בין 3-5 לשנים. שימו לב – חברות הביטוח לעיתים מושכות זמן עד לחלוף The statute of limitationsAnd all so that you don't file a claim against insurance companies. In these cases, it is important to understand whether you are suing the insurance company because you purchased the insurance policy from it or whether you are suing the insurance company because it insured a third party that caused you damage.
- Providing false/inaccurate information when purchasing an insurance policy – This is one of the most common problems before filing a claim against insurance companies, because the insured does not always provide inaccurate information intentionally. Sometimes the insured is not even aware that he provided inaccurate information. However, insurance companies are strict about this and if you read the terms of the policy carefully, you will usually find a sentence that refers to the fact that if you provide incorrect information, the policy may be canceled, and another sentence that invites you to contact the insurance company immediately if you discover inaccurate information in the terms of the insurance policy.
- The insured event does not meet the criteria set out in the insurance policy – A claim against insurance companies is filed, in the vast majority of cases, according to the terms of the insurance policy. If the insurance company claims that the event does not meet the terms of the policy, you should carefully review the terms of the policy. An example of a situation in which the insured event does not meet the criteria in the insurance policy: Let's say you have purchased personal accident insurance. The terms of the policy state that the insurance applies only from Sunday to Thursday. If you have an accident on Saturday, it will be difficult to file a claim against an insurance company for the purpose of receiving financial compensation, because the event does not meet the criteria of the specific policy you purchased.
- Vague clauses in the insurance policy – The insurance policy is not always clear on every issue, and sometimes it includes clauses that are subject to interpretation. Before filing a claim against insurance companies, it is worth checking whether your case, in which the insurance policy refers to a vague clause, has been examined in the past in court. If you find that it has and that the court ruled in favor of the plaintiff in that case, you will receive significant reinforcement for your claim. On the other hand, there are cases in which you will not find precedents and there will be no escape from being the first plaintiff to raise the claim in court.
The standard procedure before filing a claim against an insurance company
Each case must of course be examined on its own merits. In accordance with the reasons for the rejection of the payment request by the insurance company to the insured.
Do not file a claim against insurance companies immediately after a dispute arises. The best way is to first contact Warning letter before filing a claimAfter receiving the letter, a representative from the insurance company will contact you (or a lawyer on your behalf, if you are represented), and will usually request additional data/documents. This course of action is especially appropriate when it comes to Initial contact To receive payment, especially in cases where you contact the insurance company when it insures third party That caused you harm.
However, there are cases in which it is not appropriate to send a warning letter. The insurance company's reasons for rejection (and non-payment of insurance benefits to the insured) may bind it. That is, the insurance company will be prevented from asserting new claims in court. In such situations, it is not always advisable to send a warning letter in order to prevent the insurance company from adding and/or amending the arguments for rejecting the payment claim.
The insurance company's investigation may take a very long time. Sometimes many months. Always be alert to the issue of statute of limitations. As I mentioned earlier, sometimes this is a tactical approach on the part of insurance company representatives, in order to prevent you from ultimately filing a claim against insurance companies.
If you have submitted all the documents/data required by the insurance company and a month has passed, but you have not yet received a response, it is highly advisable to send a reminder letter. As the relevant date for the statute of limitations approaches, it is advisable to contact the company more often, both by phone and in writing. It is important to keep all records (copies of written requests and records of telephone contact hours, and the names of the representatives from the insurance company with whom you spoke).
If the insurance company representatives do not respond to your inquiries or reject your request, there will be no choice but to file a claim against this insurance company.
A successful method to prevent filing a claim against an insurance company
קושי או אתגר נוסף שתמיד כדאי לשים לב אליו הוא ניסיונות נציגי חברות הביטוח להגיע לפשרה לפני תביעה בסכומים מגוחכים. לדוגמה: על פי הפוליסה מגיע לכם פיצוי כספי בסך מיליון שקלים אך חברת הביטוח מציעה כ"פשרה" פיצוי כספי בסך חמישים אלף ש"ח בלבד.
שיטת מצליח זו מכוונת לאותם מבוטחים ש"לחוצים" לקבל תשלום כספי כמה שיותר מהר ושלא מעוניינים לנהל תביעה בבית המשפט כדי לחסוך זמן וכסף.
When such ridiculous settlement offers come, it is strongly recommended to consider giving them up and still file a claim against the insurance company. Of course, this should be considered after consulting with Claims lawyer An experienced insurance company that examined the case and concluded that there is indeed the potential to receive higher financial compensation after filing a claim. Civil lawsuit.
In a significant number of cases, after a claim is filed, insurance companies significantly improve the settlement offer. In these cases, it is worth considering reaching a settlement agreement rather than continuing to pursue a claim against the insurance company.
Drafting and filing a claim against an insurance company
Filing a claim against an insurance company is a complex matter, so it is highly advisable to seek the services of an experienced lawyer. It is true that it is theoretically possible to file a claim against an insurance company without a lawyer, but these attempts usually end in failure.
The claim must include all data and/or opinions that support the plaintiff's claims. Failure to address a material detail or document may lead to the claim being rejected.
It is important to remember that any attempt to amend a claim (if it is not worded correctly) will usually result in paying legal fees to the insurance company.
In conclusion
Filing a claim against an insurance company is not a simple matter. You should be aware of the possible difficulties and the terms of the policy. Filing a claim against an insurance company when the policy does not cover the event will end in failure.
An insurance company can be sued not only if it does not pay you according to the terms of the policy. A lawsuit against an insurance company can also be filed when it insures a third party that caused you damage.
Allow the insurance company to examine your claims, but it is always important to be aware of the issue of statute of limitations, and not allow the insurance company representatives to work on you and prevent you from filing your claim in court.
It is always a good idea to consult with an experienced insurance claims attorney.
Frequently Asked Questions Regarding a Claim Against an Insurance Company
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How long does a claim against an insurance company take?
The time frame for handling a claim against an insurance company varies from claim to claim. Typically, the higher the claim amount, the longer the insurance company will attempt to handle the process, all with the goal of exhausting the claimant.
This tactic will allow the insurance company to offer the claimant lower compensation than he deserves in order to get him to agree to receive some compensation in a shorter period of time. -
Does every claim against an insurance company end successfully?
not.
Like any other lawsuit, a lawsuit against an insurance company may be dismissed, and the plaintiff may be required to pay legal costs. -
Is the fee to a lawyer when suing an insurance company only based on a percentage?
No. There are cases where an advance payment is required or cases where part of the advance payment is combined with part based on a percentage of the winnings.
It all depends on the circumstances and the complexity of the case. -
What are the common costs for a plaintiff when filing a claim against an insurance company?
The main costs borne by the plaintiff are court fees, attorney fees, and expert opinions (if necessary).
Our firm represents plaintiffs and defendants in counterclaims and by insurance companies.
