What Can You Do If Your Insurance Claim Is Denied
Car accidents are stressful. This stress is amplified when either your insurer or the other party’s insurance company denies your claim. However, receiving a denial doesn’t mean that your case is over. There are still some routes you can take to resolve the issue.
There are many options you have at your disposal and by having an Edinburg personal injury attorney on your side, you can rectify a denied claim.
What Is Insurance Claim Denial?
There are a couple of different forms of insurance claim denial and they may originate from either you or the at-fault party’s insurance company. The first insurance claim denial is when your claim is denied outright. The second insurance claim denial is when you’re offered a lesser amount than what you filed for—which is usually a huge reduction.
Typically, you will receive a letter through the mail indicating whether or not your claim was approved. When denied, your letter will start with something along the lines of, “We regret to inform you …”
In the second scenario, you might also receive a check — but one lower than what you originally asked for.
In either scenario, you will likely be left confused and wondering how you will pay to fix your vehicle or cover medical expenses.
Reasons Why a Claim Might Be Denied
An insurance company utilizes insurance adjusters who are responsible for assessing and determining the insurer’s legal obligation for making a payout on each claim. Claims with damages properly calculated coupled with evidence such as testimonies are often approved without issues.
However, there are some situations where a claim can be denied:
Your claim exceeds your coverage limit
You don’t have the necessary coverage for your claim
There may be some discrepancies or doubts about your claim or even conflicting evidence
You were breaking the law when the incident happened, such as driving under the influence
You didn’t report your claim soon enough, such as reporting your claim two weeks following the accident versus within a couple of days
How to Appeal Your Claim
If your claim was recently denied, consulting a personal injury or car accident attorney should be your first objective. They will work with you in handling the appeal process.
Here are the typical steps of the appeal process:
Review the determination letter to ascertain the specific reason(s) why your claim was denied
Collect any necessary information such as your auto insurance policy and medical insurance policy
Request any outstanding documents your insurance company didn’t send, including instructions or forms for filing an appeal
Consider calling your insurer so they can help you with the appeal process
Draft a strong appeal letter with the consultation of your attorney
Submit the appeal request and make a copy of all your documents, including transcripts/summaries of any communications with your insurance company
Continue to follow up with the insurance company
While the time of the appeal process can vary, typically after filing the claim, most cases take between 30 to 45 days to be settled. Having an experienced personal injury attorney on your side can ensure the process is smoother and that you receive the justice and compensation you deserve.
The Personal Injury Team at the Law Office of Bobby Garcia Can Help!
A car accident can be a traumatic experience that can be worsened by an insurance claim denial. Following a car crash, you should consult with an experienced attorney to ensure your claim doesn’t get denied.
At the Law Office of Bobby Garcia, we have a team of experienced attorneys ready to tackle your case. Whether your claim has been denied or you’re facing a personal injury case, contact our team today!