What rights do you have when insurance denies burn claims?

What rights do you have when insurance denies burn claims?

After suffering a devastating burn injury, the last thing you need is your insurance company denying your rightful claim. Unfortunately, this happens more often than you might think, leaving burn victims struggling with mounting medical bills, lost wages, and immense physical and emotional pain. When insurance companies deny legitimate burn claims without proper justification, they may be acting in bad faith — and you have legal rights that can help you fight back. Understanding these rights is crucial for getting the compensation you deserve and holding insurance companies accountable for their wrongful denials.

Here, Fibich Leebron Copeland & Briggs explains policyholders' general rights when burn injury claims are denied.

Pro Tip: Document every interaction with your insurance company from day one — keep copies of all correspondence, record phone call dates and times, and save denial letters. This documentation becomes crucial evidence if you need to pursue a bad-faith claim.

Understanding Your Legal Rights Against Bad-Faith Insurance Practices

When insurance companies wrongfully deny burn injury claims, policyholders have powerful legal remedies available. A successful bad-faith claim against an insurer generally entitles the wronged party to receive the full amount of benefits that should have been paid under the policy. Beyond just the original claim amount, you may be able to recover additional financial losses resulting from the insurer’s actions, such as attorney fees or damage to your credit. These additional damages recognize that insurance companies have a duty to act in good faith and deal fairly with their policyholders — especially when those policyholders are dealing with the trauma of burn injuries.

Insurance companies must properly explain and support any claim denial with credible evidence. When they fail to do so, this may constitute grounds for a bad-faith lawsuit. Working with a burns lawyer can help you understand whether your insurance company’s denial crosses the line into bad-faith territory.

Pro Tip: State laws require insurance companies to respond to claims within specific time frames. If your insurer is dragging its feet or giving you the runaround, this delay itself might constitute bad faith, even before an official denial.

The Insurance Bad-Faith Claims Process: What to Expect

Understanding the timeline and process for challenging an insurance denial can help put your mind at ease during this difficult time. While every case is unique, most bad-faith insurance claims follow a predictable pattern that your burns lawyer can guide you through. The process typically begins with a thorough review of your policy, the denial letter, and all communications with the insurance company to identify specific violations of their duties to you.

• Initial claim denial review and documentation gathering (typically 1-2 weeks)
• Formal appeal to the insurance company with supporting evidence (30-60 days for response)
• Filing a bad-faith lawsuit if the appeal is unsuccessful
• Discovery phase, where both sides exchange evidence and take depositions (3-6 months)
• Settlement negotiations, which resolve approximately 85% of bad-faith cases before trial
• Trial preparation and proceedings if settlement cannot be reached (additional 6-12 months)

Pro Tip: Some states may have specific deadlines for filing bad-faith claims — typically two years from the date of denial, but this can vary based on your specific circumstances. Don’t wait to consult with an attorney, as missing these deadlines could bar your claim entirely.

Fighting Back: How a Burns Lawyer Can Help You Challenge Wrongful Denials

When facing an insurance company that has wrongfully denied your burn claim, having experienced legal representation can make all the difference. A skilled burns lawyer knows exactly what evidence to gather, which experts to consult, and how to build a compelling case that demonstrates not just the validity of your original claim but also the insurance company’s bad faith in denying it.

Success in challenging insurance denials often depends on thorough evidence and expert evaluations. Medical records detailing your burn diagnosis, treatment, and long-term prognosis are critical to establishing the legitimacy of your claim. Photographs or videos of the incident and statements from people who witnessed what happened can strengthen your case significantly. Your burns attorney will also work with medical professionals, fire investigators, and insurance industry experts who can explain how the insurance company violated its duties and the full extent of harm their denial has caused you.

Pro Tip: Keep a daily journal documenting your pain levels, medical appointments, and how the burn injury affects your daily life. This contemporaneous record can be powerful evidence of your damages and the ongoing impact of the insurance company’s denial.

The Hidden Costs of Insurance Denials for Burn Victims

When insurance companies deny burn claims, the financial impact extends far beyond just the immediate medical bills. Many burn victims don’t realize the cascading effect these denials can have on their overall financial health and recovery process. A lawyer can help you identify and document all these hidden costs, which become crucial when pursuing a bad-faith claim against your insurer. Understanding the full scope of damages helps ensure you seek appropriate compensation for everything the insurance company’s wrongful denial has cost you.

Medical Treatment Delays and Complications

Insurance denials often force burn victims to delay or forgo necessary medical treatment, leading to complications that could have been prevented with timely care. When you can’t afford the specialized burn treatment you need because your insurance wrongfully denied coverage, infections become more likely, scarring may be more severe, and your overall recovery time extends significantly. These treatment delays don’t just affect your physical health — they create additional medical expenses down the road that could have been avoided if your insurer had honored its obligations from the start.

Pro Tip: Get written statements from your medical providers explaining how insurance delays have impacted your treatment and prognosis. These medical opinions carry significant weight in bad-faith claims.

Types of Damages Available in Burn Injury Insurance Bad-Faith Cases

Understanding the full range of damages available in bad-faith insurance cases helps burn victims realize the true value of their claims. While burn injury lawsuits typically involve economic damages like medical expenses, surgeries, rehabilitation, and loss of income, bad-faith claims open the door to additional compensation. Your fire injury lawyer can pursue not just the benefits that should have been paid originally but also consequential damages that resulted from the wrongful denial — including interest, penalties, and potentially even punitive damages designed to punish particularly egregious insurance company behavior.

Economic and Noneconomic Damages in Bad-Faith Claims

Beyond the original insurance benefits, bad-faith claims can include compensation for the stress, anxiety, and financial hardship caused by the denial itself. This might include damages for credit problems that developed when you couldn’t pay medical bills, lost business opportunities because you couldn’t get proper treatment, or even the emotional distress of fighting with your insurance company while trying to recover from severe burns. Hot coffee burn injury lawsuits and other burn cases have established precedents for substantial noneconomic damages when insurance companies act in bad faith, recognizing that the harm extends beyond just financial losses.

Pro Tip: Work with a financial advisor or accountant to document all financial impacts of the insurance denial, including increased interest rates on credit cards or loans you had to take out to cover medical expenses.

Frequently Asked Questions

Common Concerns About Challenging Insurance Denials

Many burn victims have similar questions when their insurance claims are denied, and understanding your options is the first step toward getting the compensation you deserve.

Pro Tip: Bring a list of specific questions about your situation to your initial consultation — the more prepared you are, the more productive your meeting will be.

Understanding the Legal Process

The process of challenging an insurance denial might seem overwhelming, but breaking it down into manageable steps can help you feel more in control of your situation.

Pro Tip: Ask your attorney for a written timeline of your case milestones so you know what to expect and when — this helps reduce anxiety about the unknown.

1. What constitutes bad faith when a burns attorney reviews my insurance denial?

Bad faith occurs when an insurance company unreasonably denies, delays, or underpays a valid claim. This includes failing to properly investigate your burn claim, denying coverage without a legitimate reason, misrepresenting policy terms, or refusing to provide a reasonable explanation for the denial. Your attorney will look for evidence that the insurer prioritized its profits over its duty to you.

2. How long do I have to file a bad-faith claim with my burn injury attorney?

In some states, like Texas, you generally have two years from the date of the wrongful denial to file a bad-faith lawsuit. However, this deadline can vary by state and be based on specific circumstances, such as when you discovered the bad-faith conduct. It’s crucial to consult with an attorney as soon as possible to ensure you don’t miss any important deadlines.

3. Can I still pursue a bad-faith claim if my burn injuries were partially my fault?

Yes. Even if you contributed to the burn incident, your insurance company still has a duty to handle your claim in good faith. Some states follow a modified comparative fault rule, meaning you can recover damages as long as you’re not more than 50% at fault. Your insurer cannot use partial fault as an excuse to act in bad faith or completely deny valid coverage.

4. What evidence do I need for a successful fire injury lawsuit against my insurance company?

Key evidence includes your insurance policy, all correspondence with the insurer, the denial letter, medical records documenting your burns and treatment, proof of your financial losses, and any expert opinions about your injuries or the cause of the fire. Documentation showing the insurer’s investigation (or lack thereof) and their claims handling history can also be valuable.

5. Should I accept a settlement offer from my insurance company after they initially denied my claim?

Be cautious about accepting any settlement offer without legal review, especially after an initial denial. Insurance companies sometimes make lowball offers, hoping you’ll accept less than you deserve. An experienced attorney can evaluate whether the offer fairly compensates you for both your original claim and any bad-faith damages you may be entitled to receive.

Work with a Trusted Burns/Fires/Explosions Lawyer

When insurance companies wrongfully deny burn claims, having experienced legal representation becomes essential to protecting your rights and securing fair compensation. Attorneys understand the devastating impact burn injuries have on victims and their families, and they won’t let insurance companies add insult to injury by denying legitimate claims. If you’re facing an insurance denial for your burn claim, don’t wait to seek help — some state laws have strict deadlines, and the sooner you act, the stronger your case will be.

This story was produced by Fibich Leebron Copeland & Briggs and reviewed and distributed by Stacker.