What Happens If Your Insurance Company Denies Your Claim?

Posted on November 10th, 2019
By Taos Injury Lawyers

What Happens If Your Insurance Company Denies Your Claim?

When you pay for your insurance policy, you’re under the impression that if something happens, your insurance will cover your expenses. Insurance advertisements assure consumers that they’ll come through for you and that the claims process will be fast and painless.

Once you’re in an accident, you follow all the instructions that are given to you.  You answer all their questions and provide all detailed documentation that they request. Then you get the unexpected news that your claim has been denied. What happens next?

Why Would an Insurance Claim Be Denied?

When you receive notification that your claim is denied, look at the reason that’s provided for the denial. Some possible reasons that a claim might be denied include:

  • Your injuries weren’t caused by the accident
  • You (the policyholder) didn’t cause the accident
  • They dispute that your injuries are as significant as reported
  • The driver of the vehicle wasn’t covered by the policy, such as your newly licensed teenager
  • The vehicle was being used for work purposes at the time of the accident such as working as a Lyft or Uber driver but your policy doesn’t cover your vehicle being used for this purpose
  • You didn’t provide accurate information in a timely manner
  • Your coverage lapsed because you forgot to make a payment

Appealing a Denied Claim

If your claim has been denied, your next step is to file an appeal. Some of the steps you should take to do this include:

  • Check the company’s website – Your insurance company may allow you to follow the claims process online. This may help you to know as soon as the claim is denied, and instructions for disputing a denial may be detailed on the website.
  • Talk to the insurance adjuster – Your insurance adjuster may be able to answer your initial questions about how to file an appeal and how likely it is that an appeal may be successful.
  • Ask for a supervisor – If the adjuster is uncooperative or unhelpful, a supervisor may be able to provide clearer information about what went wrong and what you should do next.

There are times when an insurance company doesn’t act in good faith. The insurance company may take a long time to process your claim without providing a valid reason, only to end up denying your claim. They may have failed to notify you about changes to your policy. They may refuse to provide a reason for denying your claim that makes any sense.

Get Legal Advice About Your Denied Claim

As a consumer, it can be difficult to argue with insurance companies whose only concern is protecting their profits and paying out as little as possible. However, keep in mind that even If your claim is denied, there may still be some things you can do. It may also be beneficial to work with an attorney before filing your claim.

A lawyer who is specially trained in personal injury law can help you understand what went wrong and can help you gather evidence to increase your odds of a successful outcome. Working with a lawyer can give you a clearer understanding of how much you should ask for. A lawyer can review your policy in detail and take the time to explain your coverage to you in a way you’ll understand. If your case needs to go to court, your attorney can fight for you.

If you’ve recently had a claim denied or if you’ve been hurt in an accident, fill out the form on this page to get in touch with Taos Injury Lawyers. We’ll be in touch soon to answer your questions and see if we can help.

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