When the insurer denies a claim, offers less than what is owed or delays the settlement, the policyholder has rights. We represent individuals and companies against insurance companies so they receive the indemnity they are entitled to.
A denied claim usually arrives at the worst possible time, and the insurer's response can leave you disoriented. The good news: many denials rest on questionable interpretations of the policy exclusions, on incomplete adjustment reports or on excessive formal requirements. Before accepting a "no" or a lowball offer, a professional review of the policy and the loss is worthwhile.
Ask the company for the formal denial with its reasoning and the precise grounds. That document is the basis for assessing whether the denial complies with the policy and the law.
We analyze the general and particular conditions, deductibles and the exclusions invoked. Denials are often based on an interpretation that is open to challenge.
Claim notice, adjustment report, communications and proof of loss. A well-built file is decisive when making a claim.
Depending on the case, we challenge the denial before the company, file a complaint with the CMF and/or sue for payment of the indemnity.
We seek the best outcome by the most efficient route: a negotiated solution when convenient, or trial when it is the only way to obtain what is owed.
Fire, motor, theft, liability, life and health insurance. We challenge unfounded denials and demand payment.
When the settlement is unjustifiably delayed, we push the procedure forward, object to the report and complain about the delay.
We file the administrative complaint before the Financial Market Commission and follow it through to resolution.
Court actions to enforce the insurance contract and collect the indemnity before the competent courts.
Request the denial in writing and review the policy and the grounds invoked, because many denials rest on questionable interpretations of the exclusions. With that analysis, the denial can be challenged before the company, reported to the CMF or pursued in court.
Yes. The Financial Market Commission receives complaints from policyholders against companies. It is a useful route, but it does not replace court action when seeking actual payment of the indemnity; both can complement each other.
The settlement process has regulated deadlines. When the company or the adjuster unjustifiably delays, the policyholder can push the procedure forward, object to the adjustment report and demand payment, and also report the delay.
Send us the denial and your policy and we will tell you whether your case has merit and the best strategy.
The deadline to challenge a denied claim runs from the date of denial. Acting early protects your right before it lapses.