What Happens When a Claim is Denied?

//What Happens When a Claim is Denied?

What Happens When a Claim is Denied?

insurance claim is denied

Car accidents can shake up even the most relaxed person. Serious injuries, damage to your car and the emotional turmoil of being involved in a collision can weigh heavily on a victim. Things can become even more troubling, though, when the insurance company refuses to pay out a claim. Even when you’re certain you’re not at fault, the other party’s insurer may still deny a claim. Though it may feel like the end of the line, you still have options. Keep reading to learn why your claim may have been denied and what steps to take to get the compensation you deserve.

Reasons for Denial

Contrary to what you might expect, insurance companies have one main goal in mind when doing business: they’re hoping to turn a profit. When it comes to pleasing shareholders, being generous and helpful is just icing on the cake. The insurance company will look for any reason to deny a claim since it means saving them money. Claim denials often fall into one of two categories: either the insurance company believes there is no merit to your claim, or they hope you won’t put up a fight for the compensation you’re owed. Adjusters who rely on eyewitness accounts in absence of an official police report may choose to buy into their client’s version of the story.

Of course, there are other reasons to deny a claim. In some cases, exclusions in the policy actually waive the insurer’s responsibility. For example, an act of God exclusion could make getting compensation for your accident tough if a heavy rainstorm contributed to your accident. A lapsed policy can also because of denial. If the other party was not up to date on their premium, their policy may have lapsed. Should their insurance company argue that they had no coverage at the time, you may need to rely on your own uninsured motorist coverage to take care of medical and repair bills.

Policies also dictate precisely how long a victim has to file a claim after an accident. Fail to abide by these policies and you could be stuck footing your hospital and mechanic bills on your own. That’s why it’s so crucial to inform the insurance company of the incident as soon as possible.

Next Steps

Once your claim has been denied by the insurer, you’ll need to hire an attorney if you hope to fight their decision. No matter how valid you believe your claim to be, bringing an attorney on board can help add legitimacy to your plight. It shows the insurance company that you’re not willing to take no for an answer. Since the squeaky wheel gets the grease, working with a lawyer is the best option.

In all likelihood, your attorney will draft a demand letter to the insurance company outlining your claim, why the other driver was at fault and the dollar amount of the bodily injuries and vehicular damage sustained in the wreck. Upon receiving the demand letter, the insurance company will likely offer their reasoning behind denying the claim. The may also reverse their decision or offer partial payment of the demands.

If your attorney suspects that the insurance company isn’t playing by the rules, additional claims on such grounds can really grab their attention. State laws often forbid insurance companies from refusing to pay claims without conducting a thorough investigation first. If you have reason to suspect that the insurance company isn’t doing their due diligence, talk with your attorney about your options.

Filing a Lawsuit

In some cases, the insurance company will have a formal appeals process to go through after your claim is denied. Your attorney may be able to negotiate a settlement via arbitration. If your claim is still denied, you may have no choice but to file a lawsuit to recoup the cost of damages.

Filing a lawsuit isn’t without its drawbacks. Taking legal action is often expensive, and you may end up spending more on legal fees than the claim itself is worth. Even if you are successful in court, you could still walk away empty-handed after paying your lawyer. Have an honest talk with your attorney about your legal options before deciding whether or not to file a lawsuit.

Get the Legal Help You Need

Regardless of whether you sustained a catastrophic, life-changing injury or just need to make some minor car repairs, there’s no denying how stressful it can be to deal with the insurance company. If your claim has been denied, a car accident attorney can give you the guidance you need to get the settlement you deserve. Need help finding a local lawyer? Lawsuit Info Center can help. Crunch some numbers using our car accident settlement calculator, or call 877-810-4067 to get connected with an attorney in your area.

By |2018-08-27T16:14:07+00:00September 4th, 2018|Car Accident Lawsuits|0 Comments

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