What Can I Do If an Insurance Company Denies My Personal Injury Claim?

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Insurance Company Denies My Personal Injury Claim

If you have been injured in an accident caused by someone else’s negligence, you may be entitled to file a personal injury claim to recover damages for your medical expenses, lost wages, pain and suffering, and other losses. 

However, filing a claim does not guarantee that you will receive compensation. Sometimes, the insurance company of the at-fault party may deny your claim for various reasons. This can be frustrating and stressful, especially if you are struggling with your injuries and financial difficulties.

So, what can you do if an insurance company denies your personal injury claim? In this blog post, we detail some of the common reasons why insurance companies deny claims, how to avoid them by hiring competent personal injury attorney, and what steps you can take to challenge a claim denial and protect your rights.

Common Reasons Why Insurance Companies Deny Claims

Insurance companies want to maximize their profits. They try to pay as little as possible for each claim. They may use different strategies to reject or lower your claim. Some common reasons they use are

  • You did not file your claim on time. You missed the deadline. You have a limited time to file a personal injury claim. This is called the statute of limitations. It varies by state
  • You did not seek medical attention or follow up with your treatment. If you do not seek medical attention after the accident or fail to follow up with your treatment, the insurance company may argue that your injuries are not serious or that they were caused by something else. Therefore, it is crucial to see a doctor as soon as possible after the accident and follow their recommendations for your recovery.
  • You did not report the accident or cooperate with the investigation. If you do not report the accident to the police or your own insurance company, or if you do not cooperate with the investigation by providing evidence, witnesses, or statements, the insurance company may deny your claim on the grounds that you are hiding something or that you are not credible. Therefore, it is essential to report the accident promptly and cooperate with the investigation fully.
  • You have a pre-existing condition or a history of similar injuries. If you have a pre-existing condition or a history of similar injuries, the insurance company may try to use this against you and claim that your current injuries are not related to the accident or that they are not as severe as you claim. Therefore, it is important to disclose any pre-existing conditions or previous injuries to your doctor and your lawyer and provide medical records that show how the accident aggravated or worsened your condition.
  • You shared fault for the accident. If you shared fault for the accident, the insurance company may deny your claim or reduce your compensation based on the percentage of fault assigned to you. Depending on the state where the accident occurred, different rules may apply regarding how fault affects your recovery. 

How to Avoid Claim Denials

The best way to avoid claim denials is to prepare your case thoroughly and present strong evidence that supports your claim. Here are some tips on how to avoid claim denials:

  • Gather evidence at the scene of the accident. If possible, take photos or videos of the accident scene, the vehicles involved, the road conditions, and any visible injuries. Also, collect contact information from any witnesses who saw what happened and get a copy of the police report.
  • Seek medical attention and document your injuries. As mentioned earlier, see a doctor as soon as possible after the accident and follow their instructions for your treatment. Also, keep copies of all your medical records, bills, prescriptions, receipts, and any other documents that show how much your injuries have cost you and how they have affected your life.
  • Hire a personal injury attorney. A personal injury attorney from a trusted firm like Sawyer Injury Law can help you navigate the complex legal process of filing a claim and dealing with insurance companies. They can also help you gather evidence, negotiate with adjusters, file lawsuits, and represent you in court if necessary. A personal injury attorney can also help you avoid making mistakes that could jeopardize your claim, such as giving a recorded statement, signing a release, or accepting a lowball offer.
  • Do not admit fault or apologize. After the accident, you may feel tempted to apologize or admit fault, especially if you are feeling guilty or sorry for the other party. However, doing so could be used against you by the insurance company and reduce your chances of getting a fair settlement. Therefore, do not admit fault or apologize for anything until you have spoken to your lawyer.

What to Do If Your Claim Is Denied

If your claim is denied, do not lose hope. You still have options to challenge the denial and pursue your compensation. Here are some steps you can take if your claim is denied:

  • Review the denial letter. The insurance company should send you a denial letter that explains why they denied your claim and what evidence they used to make their decision. Review the letter carefully and look for any errors, inconsistencies, or missing information. Also, check if the letter mentions any deadlines or procedures for appealing the denial.
  • Contact the insurance company. If you believe that the denial was based on a mistake or a misunderstanding, you can contact the insurance company and ask them to reconsider their decision. You can also provide them with any additional evidence or information that supports your claim and refutes their reasons for denying it. Be polite and professional, but firm and persistent.
  • File an appeal. If contacting the insurance company does not work, you can file an appeal with the insurance company’s internal review board or an external review agency, depending on the type of claim and the state where the accident occurred. An appeal is a formal request for a higher authority to review your claim and overturn the denial. You will need to submit a written appeal letter that explains why you disagree with the denial and provides evidence to back up your arguments. You may also need to submit additional documents, such as medical records, witness statements, or expert opinions.
  • File a lawsuit. If all else fails, you can file a lawsuit against the insurance company in court. A lawsuit is a legal action that seeks to hold the insurance company accountable for acting in bad faith and violating your rights. Bad faith is when an insurance company acts unreasonably, dishonestly, or unfairly in handling your claim. If you can prove that the insurance company acted in bad faith, you may be able to recover not only your original damages, but also additional damages for emotional distress, punitive damages, and attorney fees.

    However, filing a lawsuit is not an easy or quick process. It can be costly, time-consuming, and stressful. Therefore, it is advisable to consult with a personal injury attorney before taking this step.

Conclusion

If an insurance company denies your personal injury claim, do not give up on your right to compensation. You can take action to challenge the denial by a dependable hiring law firm like  Sawyer Injury Law in Atlanta to protect your interests. A personal injury attorney can help you with every step of the process and fight for your best outcome.