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Publication date: 21.11.2024
What to do in case of denial of insurance payment in Poland?
Denial of insurance payment can be a serious financial blow for Ukrainians living in Poland. The service of legal analysis of a situation, verification of documents by a lawyer will help to understand the reasons for the refusal and find ways to solve the problem. It is known from practice that more than 40% of refusals can be successfully appealed with the help of qualified lawyers. Consider a case from our practice: a client was denied health insurance due to alleged concealment of a chronic illness. The legal document analysis service helped prove that the client was unaware of his illness at the time of concluding the contract, and the insurance company paid full compensation.
Common reasons for denial of insurance claims
Understanding the reasons for the refusal is the first step towards a successful solution. The service of a lawyer in Poland will allow you to identify the true grounds for refusal and assess the prospects for appeal. According to statistics, most often denials are related to formal reasons that can be successfully appealed.
The most common grounds for refusal are:
- Errors in the execution of the insurance policy or claim form
- Violation of the terms of the insurance contract
- Late notification of the insured event
- Providing incomplete or inaccurate information
- Lack of necessary documents or their incorrect execution
- Expiration of the contract
- Occurrence of an uninsured event
- Failure to comply with the terms of operation of the insured property
Real examples from practice
Our experience shows that the service of a lawyer's consultation often helps to identify the unreasonableness of the refusal. Let's consider specific cases from practice:
Successful cases:
- Denial of payment in case of an accident due to “violation of the rules”
- Refusal under the CTP policy due to “incorrectly executed Euro protocol”
- Underestimation of the amount of payment in case of property damage
- Refusal due to “untimely” notification of the insured event
- Refusal to pay due to “insufficient” documents
In one of the cases, the client was denied payment after the apartment was flooded, citing the fact that he had not taken sufficient measures to reduce the damage. The legal opinion service helped to prove that the client acted reasonably and in a timely manner, and the insurance company paid the compensation in full.
Question
What documents are needed to appeal an insurance company's refusal?
Answer
To successfully appeal the refusal, you need to collect a full package of documents, including the insurance policy, documents on the insured event, correspondence with the insurance company, evidence of losses incurred, photos and videos, expert opinions, acts of inspection of damaged property, medical records (if it is a health injury), police reports and other documents depending on the type of insured event. The service of legal analysis of a situation will help you determine what documents are missing and how to properly execute them.
Common mistakes when appealing a refusal
Incorrect actions can make it much more difficult to receive a payment. The legal analysis service and the online lawyer service will help you avoid common mistakes and increase your chances of success.
Critical mistakes in the appeal process:
- Missing the deadlines for filing a claim and lawsuit
- Incomplete set of documents or their incorrect execution
- Unreasonable or excessive claims
- Lack of proper evidence base
- Incorrectly drawn up claim or statement of claim
- Independent negotiations without legal support
- Agreeing to unfavorable terms of settlement
Algorithm of actions in case of refusal
A professional approach to solving a problem increases the chances of success. The legal opinion service and the legal analysis of the documents service will ensure the correct sequence of actions.
Step-by-step instructions:
- Obtaining a written refusal and its detailed analysis
- Consultation with a lawyer on the prospects of the case
- Collection of additional documents and evidence
- Conducting an independent examination (if necessary)
- Drawing up and submitting a claim
- Negotiating with the insurance company
- Filing a complaint with the supervisory authorities
- Preparation for the trial
Pre-trial settlement of the dispute
Most disputes can be resolved without going to court. The service of lawyer's consultation and the service of a lawyer in Warsaw will help you choose the best negotiation strategy and save time and money.
Question
How long can it take to receive an insurance payment through the court?
Answer
Litigation to recover insurance benefits in Poland can last from 6 months to 2 years, depending on the complexity of the case and the position of the insurance company. The legal opinion service and the online lawyer service will help you optimize this process and increase the chances of a positive decision.
Preparation for the trial
If the pre-trial settlement has not yielded results, it is necessary to carefully prepare for the trial. The legal analysis of a situation service and the lawyer service will provide professional support of the case.
Key stages of preparation:
Detailed study of court practice in similar cases
Calculation of court costs and preparation of evidence of their incurrence
Preparation of a statement of claim and supporting documents
Formation of a convincing evidence base
Involvement of witnesses and experts to confirm the position
Preparation of legal position and counterarguments
Preventing problems in the future
Prevention is always better than cure. The legal analysis service and the lawyer service will help to avoid problems when issuing new insurance policies.
Preventive measures:
- Detailed analysis of the insurance contract before signing
- Fixation of all essential insurance terms and conditions
- Keeping all documentation and correspondence
- Timely informing the insurer about changes in circumstances
- Regularly checking the relevance of the policy
- Documentation of insured events from the moment of their occurrence
Refusal to pay insurance claims is a serious problem that requires a professional approach to solving. Delays may result in the loss of the right to compensation due to the missed appeal deadlines. In addition, independent attempts to resolve the conflict often lead to mistakes that make it difficult to further protect your rights. Inaction or incorrect actions can cost you significant money and nerves. Do not risk your money - entrust the protection of your interests to the professionals of the legal marketplace CONSULTANT. Our specialists have extensive experience in successfully resolving such cases and will provide you with qualified support at all stages of the process. Contact us, and we will help you get the insurance payment you deserve.
