Can I sue an insurance company for denying a valid claim

UPDATED: Sep 30, 2022

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Can I sue an insurance company for denying a valid claim

I applied for coverage
with their supplemental
insurance company in
December 2016 my
coverage took effect on
01/07/2017. I had an
MRI and x-rays on the
16th of the month which
resulted in needing
surgery . My claim was
denied as pre-existing
because I saw a doctor in
November for neck pain.

Asked on April 13, 2017 under Insurance Law, New Hampshire


SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 5 years ago | Contributor

Yes, if you believe that the insurer is not honoring their contractual obligation (an insurance policy is a contract), you can sue them for "breach of contract" for the money which they should have paid. To prevail in court, you would have to convince the court by a "preponderance of the evidence" (that it is "more likely than not") that under the terms of the policy (since like any contract, an insurance policy is enforced in accordance with its plain terms) and facts of the situation, that they should have paid. Bear in mind that you cannot recover any legal fees, if you sue: you will have to pay these yourself.

IMPORTANT NOTICE: The Answer(s) provided above are for general information only. The attorney providing the answer was not serving as the attorney for the person submitting the question or in any attorney-client relationship with such person. Laws may vary from state to state, and sometimes change. Tiny variations in the facts, or a fact not set forth in a question, often can change a legal outcome or an attorney's conclusion. Although has verified the attorney was admitted to practice law in at least one jurisdiction, he or she may not be authorized to practice law in the jurisdiction referred to in the question, nor is he or she necessarily experienced in the area of the law involved. Unlike the information in the Answer(s) above, upon which you should NOT rely, for personal advice you can rely upon we suggest you retain an attorney to represent you.

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