Claim

Health Insurance Claim Form
Black’s Legal Dictionary defines a claim as “a demand for compensation” while Cornell Law School defines it more technically as “a set of operative facts creating a right enforceable in court.” Utah law defines it as any demand for money or damages arising from state laws against a person or organization. Utah’s law on insurance defines “claim” as “a request or demand on an insurer for payment of a benefit according to the terms of an insurance policy.”  That is to say, you make a claim by requesting the coverage you buy from your insurance provider. Claims can refer to either insurance or legal suits that can be settled through a lawsuit.

Example Sentence

After his motorcycle accident, Doug made a claim with the other driver’s insurance company to pay for his medical bills.

Case Study

One of our cases involved two women who’s mother had been killed in a car accident. They made a wrongful death claim with their insurance company, but the company would not treat them fairly because of their mother’s advanced age and medical conditions. The sisters hired us because they had a legal claim to the insurance policy. We showed the insurance company that their mother still would have had many years left if not for the accident. They offered a low settlement amount for the claim, so we took them to arbitration where the family received double the amount the insurance company offered.

Other Important Information

Attorneys may also refer to a claim as a cause of action. The person who files the claim is known as a “claimant.” Filling out a claim can be a long and complicated process requiring a detailed documentation of injuries, storing of all receipts, and memorizing seemingly endless details.  The procedure might vary slightly in order or length according to accident type, level of severity, etc.  In making any sort of insurance claim, it is vital to be honest, strictly factual (neither assigning nor accepting blame), detailed, and consistent. For more information on this process, see our guide to filing an insurance claim. Utah Law requires the insurance company to promptly investigate and respond to the person’s claim. They must either offer a predictable settlement of an amount proportionate to the coverage purchased or deny the claim and give specific reasons for the denial.If they fail to follow the contract’s agreement or offer significantly less than what their contract requires, you may need to call a personal injury attorney to fight their arguments. Similarly, Utah law prohibits insurance companies from doing other unfair practices in order to save their company money. Utah also allows claims that are not settled promptly to start gaining interest.

ImageHCFA 1500 Insurance Claim Form” copyright by Chris Meller.

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