Michael J. Lucas & Associates, LLC helps policyholders evaluate denied claims and determine whether the insurer's position is supported by the contract and Illinois law.
Start With the Policy and the Denial Letter
Insurance coverage is contractual. The declarations, coverage forms, endorsements, exclusions, definitions, conditions, and amendments should be reviewed together.
A denial letter should identify the factual and policy basis for the insurer's position. Sometimes the dispute concerns whether the loss falls within the initial grant of coverage. In other cases, the insurer relies on an exclusion, condition, late notice, valuation issue, or disagreement about the amount of loss.
Claim Denial Is Not the Same as Bad Faith
An insurer can deny a claim and later be found wrong without every incorrect denial being vexatious or unreasonable. Illinois law provides a potential statutory remedy in certain cases where an insurer's conduct or delay is found vexatious and unreasonable, but that determination is fact specific.
The focus should first be on whether coverage exists and what the policy requires.
Evidence Supporting the Claim
Depending on the loss, relevant information may include photographs, repair estimates, inventories, medical records, expert reports, police or fire reports, proof of ownership, business records, communications with the insurer, and documentation showing compliance with policy conditions.
A complete claim record can help identify whether the dispute is factual, contractual, or both.
Appeals, Reconsideration, and Litigation
Some disputes can be resolved by providing additional information or challenging the insurer's interpretation. Others may require a formal demand, appraisal or arbitration where applicable, declaratory judgment action, breach of contract suit, or other litigation.
The appropriate procedure depends on the policy and the nature of the claim.
Deadlines Matter
Insurance policies can contain notice requirements, proof of loss requirements, suit limitation clauses, arbitration deadlines, and other time sensitive provisions. Statutory deadlines may also apply.
If your insurance claim has been denied, Michael and his team can review the policy and denial, identify the disputed provisions, evaluate the supporting evidence, and help you determine whether reconsideration, negotiation, or litigation is appropriate.
Areas We Serve
Michael J. Lucas & Associates, LLC assists clients throughout Boone County, Cook County, DuPage County, Kane County, Lake County, McHenry County, and Will County.
Our office serves clients throughout Northern Illinois, including Addison, Algonquin, Antioch, Arlington Heights, Aurora, Barrington, Bartlett, Batavia, Belvidere, Bloomingdale, Bolingbrook, Buffalo Grove, Carpentersville, Cary, Chicago, Crystal Lake, Deerfield, Des Plaines, Downers Grove, Elgin, Elk Grove Village, Elmhurst, Evanston, Fox Lake, Fox River Grove, Frankfort, Geneva, Glen Ellyn, Glenview, Grayslake, Gurnee, Hanover Park, Hampshire, Harvard, Highland Park, Hoffman Estates, Huntley, Joliet, Lake Barrington, Lake Forest, Lake in the Hills, Lake Zurich, Libertyville, Lincolnshire, Lisle, Lockport, Lombard, Marengo, McHenry, Mokena, Mount Prospect, Mundelein, Naperville, New Lenox, Northbrook, Palatine, Park Ridge, Plainfield, Poplar Grove, Prospect Heights, Rolling Meadows, Romeoville, Roselle, Schaumburg, Shorewood, South Elgin, St. Charles, Streamwood, Sugar Grove, Vernon Hills, Waukegan, West Chicago, Wheaton, Wheeling, Wilmette, Winfield, Wood Dale, Woodridge, and Woodstock.