Why an Attorney Should File Your Insurance Claim

Legal help can get you further, faster, in Colorado

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Insurance is an unfortunate reality of American life, as is the fact that insurance is a business, and is therefore out to make money. Their job, simply put, is to resolve claims for as little as they are legally required, which often leaves policyholders with the short end of the stick. The good news, though, is that you don’t have to go it alone.

“The company will say, ‘We owe what we pay, and pay what we owe—not a penny more or a penny less,’” says Thomas W. Henderson, an insurance coverage attorney at Burg Simpson in Englewood. “That may be true, but they’re also looking for places to save pennies, and they won’t tell you where they make those left turns as opposed to, just as easily, going right to pay a lot more. If they hire a lawyer who knows and understands where those turns are made, they can point out to the insurance company the route they should have taken.”

Henderson estimates that two-thirds of his calls are from policyholders whose insurance carriers have denied their claims, but another third are before that point and already “at wit’s end.”

“I see so many clients who are extraordinarily frustrated—even before a denial—because it’s a process that’s hard to understand,” he adds.

Hiring a lawyer on the front end is helpful because they know not only policyholder rights and responsibilities, but the company’s, too. They also know what the insurer requires in order to properly adjust the claim.

“Policyholders may misunderstand what the insurance company is asking for, but we can help to navigate these totally unfamiliar waters,” Henderson says. “Most of the time, policyholders don’t understand the coverages that they have in their policies—they say, ‘This is all Greek to me.’”

A lawyer can look at your policy and tell you what you’re entitled to—even in areas you may not expect. “For example, there have been many forest fires recently, and oftentimes there is coverage for damage to trees on a property,” Henderson says. “There are, sometimes, other buckets to categorize damages such that you can get more coverage, and a lawyer should know where those nooks and crannies are in a policy.”

Another example, he says, would be a kitchen fire. If you try to navigate it on your own, you may very well secure an amount that replaces everything directly damaged by the fire. But what about smoke damage? Henderson says items like furniture and clothing may also be irreparably damaged, and he has made such claims successfully.

“From a pre-claim perspective, there’s an awful lot that can be done to present your claim in the best way possible, to get it paid in a timely manner and for the maximum amount,” he adds.

The law in Colorado is that insurance exclusions are to be narrowly interpreted, but Henderson says that isn’t always the practice. How you present your claim can be key under these circumstances. “For instance, if it’s a mold claim, most policies exclude it. But what if the mold resulted from water?” he says. “Now it would be important in the presentation of the claim not to emphasize the mold part, but the water that caused it.”

Colorado

“Policyholders may misunderstand what the insurance company is asking for, but we can help to navigate these totally unfamiliar waters. Most of the time, policyholders don’t understand the coverages that they have in their policies—they say, ‘This is all Greek to me.’”

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