If you were injured in a car accident, and the other driver was at fault, you may be eligible for financial compensation by filing a personal injury claim. However, to recover the damages you are entitled to, you must prove that the other driver was responsible for causing the accident. If you do not have sufficient evidence, your claim may be denied. There are several other reasons that an insurance company may deny a claim to avoid paying a large settlement. You can take proactive steps to avoid a denial or appeal a claim that your insurance company denies. An experienced car accident lawyer can help you navigate this process and negotiate the outcome of a successful claim.
Why Would My Insurance Company Deny a Claim?
After reviewing your claim, your insurance adjuster may deny your car accident claim for several reasons, including the following:
- Your insurer determined that you were at fault. This is one of the most common reasons an insurance provider will deny a claim. If there is evidence that you ran a red light, were tailgating, or said something that could be interpreted as an admission of guilt, your claim may be denied.
- You do not have relevant medical records. If you are seeking compensation for medical expenses associated with an injury caused by the accident, you will need to provide copies of medical records. If you cannot supply these documents, your insurance company will likely deny your claim based on a lack of evidence.
- Your actions are excluded from coverage. Your insurance company may deny your claim if there is proof that you engaged in the following behaviors:
- Drunk driving.
- Driving with an expired or suspended license.
- You filed a claim with your auto insurance, but your vehicle was used for commercial purposes at the time of the accident.
- Your damages exceed your policy limits. Serious accidents that result in life-threatening injuries result in damages that can quickly accumulate to a point that exceeds your policy limits. Your insurance company may offer a limited amount or simply deny your claim.
- There is a question about liability. If there is insufficient evidence or conflicting statements, the insurance company may deny the claim, arguing that there is a chance that you were at least partially responsible for causing the accident.
- There was a lapse in your insurance coverage. If you missed a payment or allowed your policy to lapse, your insurance company will deny any claims filed during the delinquent period.
- You had a preexisting condition. Insurance companies will look for any reason to deny a claim, including the existence of a preexisting condition. Your claim may be denied if your insurance provider can prove that your injuries were not solely caused by the accident. Copies of medical records and a statement by a medical expert will help support your claim.
- You failed to seek immediate medical attention. If the insurance company discovers that you did not seek immediate medical attention, or there was a significant gap in time from when the accident occurred and when a medical professional examined you, they may claim that your injuries must be minor if you did not find it necessary to get immediate medical attention.
- The at-fault motorist is uninsured or underinsured. In Georgia, motorists are not required to carry uninsured motorist coverage. If the other driver does not have insurance, is underinsured, or flees the scene of the accident, and you do not have uninsured motorist coverage, your claim may be denied.
How Can I Avoid a Claim Denial?
There are a number of things you can do to ensure that you have a successful claim and recover the damages that you are entitled to, including:
- Collect as much evidence as possible. This is crucial to proving your claim and avoiding a dispute with your insurance company. Obtain a copy of the police report, take photos of the accident scene, get witness statements, and exchange contact and insurance information with the other driver.
- Seek immediate medical attention. It is imperative that you are examined by emergency medical personnel at the scene of the accident to diagnose and treat your injuries, including those that may not have obvious symptoms.
- Understand your policy in general. Knowing what is and is not covered by your insurance policy is helpful when filing a claim.
What Steps Should I Take If My Claim Is Denied?
If your claim is denied, and you believe that the insurance company made an error, it is highly recommended that you contact an experienced car accident lawyer who will thoroughly review your case, including the evidence provided and the reason for the denial. In some cases, the reason may be a lack of evidence, in which case you can submit additional evidence supporting your claim, like a police report or updated medical records.
Your lawyer will assist you with drafting an appeal letter, identifying why you disagree with the insurance company’s decision. The letter should be as detailed as possible, referencing specific policy information and where you disagree with the provider’s decision to deny your claim. Your lawyer will also draft a demand letter that requires the insurance company to respond and defend its reason for denying your claim.
Our Cincinnati Car Accident Lawyers at Wolterman Law Office Assist Clients Whose Claims Were Denied
If you were injured in a car accident and your personal injury claim was denied, contact our Cincinnati car accident lawyers at Wolterman Law Office as soon as possible. We understand the tactics that insurance companies use to avoid paying claims. To schedule a free, confidential consultation, call us today at 513-488-1135 or contact us online. Located in Loveland, Ohio, we serve clients in Hamilton County, Fairfield, Norwood, and Forest Park.