It can be assumed that every household in the Federal Republic of Germany has taken out several insurances. Insurance is a special form of risk assumption on a collective basis. With a corresponding amount of money – the insurance premium – the possible realization of a life risk is jointly borne, so that the individual is relieved of it. The basis of risk shifting is in each case an insurance contract. Insurance contracts are very complex contracts, each of which contains a large number of standardized contractual conditions – so-called General Terms and Conditions (GTC).
The insurance contract determines the rights and obligations of the participants. In many cases, when the insured event occurs, a situation arises unexpectedly in which the insurer delays or refuses payment. For the policyholder, this may result in a situation that threatens his existence in financial terms. Now insured persons need qualified legal advice quickly. Ideally, this can be done by a lawyer specialized in insurance law, such as here at Lamster& Law Office Partner Freiburg provide.
The contractual environment in insurance law
When talking about insurance law in the context of legal services, it is regularly about the many different classes of private insurers. This area includes all private liability insurances, such as private personal liability and motor vehicle insurance. Further it concerns here the large topic occupational disability insurance and the typical insurances of property such as the household, building, fire, storm and burglary insurance, in order to call only some examples. Private accident insurance also has its place here and is of great practical importance, as is private health insurance. It goes without saying that existential risks are often insured in this area. If the insurance benefit fails, this is very stressful for the insured person.
As a rule, in addition to the main contractual obligation in the form of payment of the insurance premium, the insured person must also fulfill various obligations, especially when the insured event occurs. Many of these obligations are hidden in the so-called "small print" of the insurance contract. As a result, they are often neither sufficiently acknowledged nor taken seriously enough by insured persons. It is precisely in the context of these obligations that typical disputes arise about the insurance companies' obligation to pay in the event of a claim. However, there may be other reasons why insurers do not want to pay.
What can insured persons do to minimize the risk of payment refusal?
Careful reading of the terms and conditions of the contract can save many a question at the lawyer's office. If you as a policyholder deal with the relevant clauses before the occurrence of an insured event, ideally at the time of the conclusion of the contract, you will be in a better position to assess your obligations. For example, it is important that the occurrence of a loss event is immediately reported to the insurer. In the insurance-legal practice it worked satisfactorily also not to cover each general life risk with a special insurance protection. Often, for example, insurance contracts for the cell phone or for the possible loss of luggage are so cleverly designed on the part of the insurer and provided with appropriate benefit exclusions that the insurer's obligation to pay in this case is rarely given. If there are difficulties with an insurer, however, insured persons should not wait before seeking qualified legal advice. In certain circumstances, deadlines must be observed when asserting a claim, and establishing the facts becomes more difficult with each day that passes. Going to the lawyer should not be postponed. The law firm Lamster& Partner in Freiburg is available to you with the specialist lawyer for insurance law Martin Lamster, if it concerns questions of insurance law.
What can your specialist lawyer for insurance law do for you if the insurer does not want to pay?
The reasons for an insurer's refusal to pay can be manifold. Possibly there is actually a breach of obligation on the part of the policyholder or the damage is not covered by the corresponding insurance policy. The policyholder may be underinsured, or the insurance company may be methodically slow to settle claims when they occur. A specialist lawyer experienced in insurance law can already exclude certain reasons for a refusal to pay after examining the insurance contract. In the event of slow processing of the insurance claim, he or she can demand swift settlement by means of an appropriate reminder letter from a lawyer, setting a deadline.
In many cases, further out-of-court steps, for example in the form of a letter of complaint to the complaints management of the insurance company concerned or to the responsible ombudsman's office, lead to success.
In any case, your specialist lawyer for insurance law will exhaust all extrajudicial possibilities before deciding, together with you, on a judicial assertion of the payment claim in case of a definite refusal of payment by the insurance company. He will also check for you whether a legal expenses insurance company will cover the costs of the proceedings. Legal disputes with insurers are often sparked by questions of evidence and findings of fact. Your experienced lawyer in insurance law knows how to lead evidence and how to evaluate expert opinions.
Entrust yourself in insurance law only to experienced specialists.
In case of disputes arising from insurance contracts, the law firm Lamster& Partner from Freiburg Your first point of contact.