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When filing a workers’ compensation or personal injury claim, the expectation is that the insurance company will respond promptly, providing the necessary benefits without delay. However, delays in insurance claims are all too common, often resulting in financial hardship for injured individuals waiting on payments for medical treatment and other expenses. In Los Angeles, working with an experienced delayed claim attorney, such as Hinden & Breslavsky, can make a significant difference in obtaining a fair settlement and holding the insurance carrier accountable for unnecessary delays. Our law firm has helped numerous clients secure compensation when faced with delayed or denied claims.

Understanding Delayed Claims and Insurance Company Tactics

Insurance companies may delay claims for a variety of reasons, some legitimate and others questionable. Common reasons an insurer may delay a claim include:

  • Missing documentation or policy details
  • Confusion over insurance policies or benefits
  • Claimant’s medical treatment not clearly linked to the accident
  • Investigation delays to verify facts or other evidence
  • Administrative backlogs

Unfortunately, delays can indicate possible bad faith insurance practices, where the insurance company intentionally withholds payment without a valid reason. If the insurance company refuses to process or approve your claim in a timely manner, Hinden & Breslavsky can assist you in challenging these delays and seeking the benefits you are entitled to receive.

Insurers may delay claims to limit their coverage payouts, save costs, or discourage claimants from pursuing the compensation they deserve. Some insurers may wait for the claimant to give up due to mounting legal fees or frustration. Recognizing the tactics of insurance carriers can help you make informed decisions about your workers’ compensation case or personal injury claim.

Common Reasons for Delayed Insurance Claims

Several common reasons lead to delays in insurance claims:

  1. Incomplete or Incorrect Information: Missing policy details or other evidence can halt claim processing.
  2. Disputes Over Medical Necessity: Disagreements about the necessity or costs of medical treatment may cause delays.
  3. Investigations: Some insurers require additional investigations before approving a claim, especially in workers’ compensation cases.
  4. Payment Delays: Administrative backlog or processing issues often stall payments.

Each of these reasons could result in delayed access to the compensation you deserve. The attorneys at Hinden & Breslavsky are well-versed in helping clients combat delays and pursue fair outcomes.

How Hinden & Breslavsky Can Help with Delayed Claims

As a reputable law firm with experience in insurance law, Hinden & Breslavsky understand how to hold insurance carriers accountable. Our legal team can examine your case, identify instances of bad faith, and assist in gathering essential documents and evidence to support your claim.

Identifying Bad Faith Insurance Practices

When insurance companies engage in bad-faith insurance tactics, they may act in a way that violates good-faith principles. Recognizing these tactics is critical for obtaining a fair settlement. Bad faith practices may include:

  • Denying claims without justification
  • Failing to respond to claims in a timely manner
  • Delaying payment without cause
  • Misrepresenting policy details
  • Failing to thoroughly investigate the claim

If an insurer denies your claim or delays payment without a valid reason, they may be acting in bad faith. Hinden & Breslavsky, as bad faith insurance lawyers, can guide you through the process of proving bad faith and pursuing the compensation you deserve.

Legal Recourse for Delayed Claims and Denial Letters

When a denial letter is issued, the reasons provided by the insurance company must align with the details outlined in the insurance policy. If the insurer denies a claim based on missing information or vague reasons, they may be legally required to provide further explanation. At Hinden & Breslavsky, we will scrutinize your denial letter and insurance policy to determine if your claim has been unfairly denied.

Types of Compensation You May Be Entitled To

If your insurance claim is delayed or denied, you may be eligible for various forms of compensation, such as:

  • Medical expenses related to your injury or illness
  • Lost wages if your injury prevents you from working
  • Punitive damages for instances of bad-faith insurance practices
  • Reimbursement of legal fees incurred in challenging the claim denial

Our attorneys will assess your case to determine which damages you may be entitled to pursue.

Steps to Take if Your Insurance Claim Is Delayed

If your insurance claim is delayed, consider the following steps:

  1. Contact the Insurer: Ask for specific reasons for the delay.
  2. Submit Additional Documentation: Provide any missing information that may be necessary.
  3. Seek Legal Advice: An attorney from Hinden & Breslavsky can help you understand your rights.

Our law firm is dedicated to helping injured individuals secure their rightful benefits. With experience representing numerous clients, we have a thorough understanding of insurance law and the intricacies of delayed claims. Our Los Angeles attorneys will work closely with you to address any concerns related to your claim, ensuring you receive the coverage and support you need.

Recognizing Signs of Bad Faith in Delayed Claims

When an insurance company delays payment without a valid reason, it could be a sign of bad faith. Indicators of bad faith include:

  • Lack of communication from the insurance carrier
  • Denial letter without clear explanation
  • Unwarranted delays despite ample documentation
  • Failing to fulfill agreed-upon insurance policy terms

If you suspect bad faith practices, Hinden & Breslavsky can help you pursue compensation and protect your rights.

How Does The Workers’ Compensation 90-Day Rule Affect You?

In California, workers’ compensation insurance companies must respond to all workers’ comp claims within 90 days. If your claim isn’t denied within 90 days, it will be presumed accepted. Additionally, while the insurer makes its decision, they are responsible for paying your medical bills up to $10,000 – even if they end up denying your claim.

If it’s been more than 90 days and you have not received a decision (or payments) on your workers’ compensation claim, or if you’ve received a Notice of Delay, contact Hinden & Breslavsky. Our Los Angeles delayed workers’ compensation claim lawyers can help you determine the best course of action going forward.

Call us to request a free consultation with a member of our legal team. You owe us nothing unless/until we successfully recover compensation on your behalf.

Understanding Your Rights

Workers’ compensation is a no-fault system; this means that you do not have to prove that negligence or fault played any role in your injuries/illness. Instead, you must only show that your injuries/illness occurred while you were at work, as a result of your work-related duties or while you were carrying out said duties.

Once you have notified your employer of your injury/illness (within 30 days) and filed the DWC-1 form, your employer has 14 days to accept, deny, or delay your claim.

If your claim is delayed, there are a number of important things you should be aware of:

  • Your claim must be accepted or denied within 90 days.
  • During the delay, you are eligible to receive up to $10,000 for your medical expenses.
  • The insurance company is not responsible for lost wages during the delay.
  • You may be able to recover compensation for lost wages through the state’s disability program.
  • You may need to visit a doctor chosen by your employer for your first visit, but you do not need to continue seeing this doctor; you may choose a doctor in the Medical Provider Network.
  • You may need to be evaluated by a Qualified Medical Evaluator (QME) during the 90-day delay.
  • If your claim is not denied within 90 days, it is presumed “compensable,” meaning you are eligible to receive benefits.

Get Started On Your Case Today

The Los Angeles delayed workers’ compensation claim lawyers at Hinden & Breslavsky can help you if your claim has been denied. We understand the various processes involved and, with over 150 combined years of legal experience, we know what it takes to fight for the maximum compensation you are owed.

Our team has represented thousands of injured workers throughout California and successfully recovered over $900 million. We are prepared to guide you throughout each stage of the process, answering your questions and addressing your concerns along the way.

If your workers’ compensation claim was delayed, or if you have not yet received your rightful benefits, give us a call (323) 954-1800 at or send us an email. Your initial consultation is free.

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OUR ADVANTAGES

Why Choose Us?

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MULTILINGUAL
FIRM

We offer services in English, Spanish, Russian, Hebrew & Farsi.

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AGGRESSIVE ADVOCACY

Our team will vigorously advocate on your behalf so that you can put all of your attention into your health.

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TEAM-BASED APPROACH

When we represent you, all of our dedicated professionals will be behind your case.

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EXPERIENCE & DEDICATION

With more than three decades of experience, we know what strategies are most effective for obtaining maximum compensation for our clients.

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CONTACT US NOW

Our attorneys, hearing representatives and support staff members are dedicated to helping our clients get their lives back on track. Have questions regarding your claim? Our team has the answers.
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