Involving Legal Professionals in Your Claim

Is Involving Legal Professionals Necessary for Your Insurance Claim?

While the optimism of seeing the world through rose-colored glasses may suggest otherwise, the complexities of insurance claims can make legal assistance invaluable. Discover why having someone advocate for your best interests is crucial in the modern insurance landscape, where carriers aim to protect every cent.

Public adjusters typically handle claim advocacy effectively, rendering attorney involvement unnecessary. However, there are scenarios where legal assistance becomes vital:

Coverage Denial and Refusal to Negotiate

In instances where insurance coverage is denied or negotiations are refused, consider involving legal professionals. Legal professionals work to challenge denials, advocating for policyholders’ right to secure the coverage they’re entitled to. Legal professionals can also engage in negotiations with insurance carriers, striving for a settlement that is fair and reasonable.

Policy Interpretation Issues

Insurance policies often involve intricate language open to interpretation. Legal assistance becomes essential when disputes arise over policy terms. Attorneys can provide clarity on policy language, aiming to safeguard the rights of policyholders and that carriers adhere to the agreed-upon terms.

Bad Faith Practices by Insurance Carriers

Bad faith practices occur when an insurance carrier acts dishonestly or unfairly toward a policyholder. This includes unreasonably delaying claims processing, undervaluing claims, or wrongfully denying valid claims. Legal professionals can identify and challenge such practices, holding carriers accountable for acting in good faith and aiming to maintain fair treatment throughout the claims process.

Beyond the situations highlighted above, there are less apparent, yet valid reasons to consider legal counsel. Chip Merlin of Merlin Law Group, discusses one of these less apparent reasons in his blog “Insurance Company Claims Adjuster Bonus Programs and Criteria.” Some carriers may incentivize adjusters to underpay claims, making it crucial to involve legal representation. Legal professionals can file discovery motions to uncover any undisclosed bonuses that may compromise the fairness of claim payouts.

Uncovering these bonus programs may be challenging, as carriers often attempt to disguise them. An attorney, equipped with the expertise to refine discovery requests, can reveal less savory bonus programs. While not every claim requires legal intervention, having an attorney available ensures that, if needed, assistance is just a phone call away.

Explore the nuances of public adjusting claims and understand when legal involvement can make a significant difference in securing a fair and favorable settlement.

By: Ashley Balsbaugh | Associate Attorney

Meticulous Documentation Leads to a 683% Increase in the Settlement

Elite Transportation Warehouse

Emporia, Kansas
Hail & Water Damage
November 2021


Despite presenting evidence from forensic damage experts that proved water intrusion had caused phenolic insulation to become acidic and cause damage to the steel decking, the insurance carrier remained steadfast with their $139,000 estimate. They also denied coverage for business losses, even though the policy clearly included it. Undeterred, we connected the policyholder with a legal team, sharing all our findings to build a solid case. The outcome? A victory that resulted in a 683% increase in the settlement offer from the insurance carrier.


Insurance Carrier Offer: $139,000

Premier Claims Settlement: $1,088,000