What to do when your car accident claim is denied

Car accident claim denied – now what?

When an insurance company denies a car accident claim, there can be numerous reasons. Some of these reasons are legitimate. For example, if the claimant falsely reported injuries or damages or if someone else is responsible for the costs, the insurance company has a right to deny the claim. However, it is also possible for a victim who makes a good faith claim against an insurance policy to be denied unfairly.

Just because a car accident claim is denied does not mean that the victim should give up all hope, however. The victim still has the option to submit an argument against the claim denial or to pursue a claim by hiring an experienced car accident attorney and filing in court. Filing an appeal or pursuing a lawsuit against the insurance company could result in the claim being paid, either partially or fully.

Understanding a Car Accident Claim Denial

A car accident claim can be denied for a number of reasons, so it is very important to understand why the company is refusing to pay the claim before taking action. Any denial should generate a letter explaining in writing the reason the company is refusing to honor the request to pay for damages or injuries.

There could be many different reasons an insurance company gives for refusing to pay the claim. Reasons for rejection of a claim could include;

  • Improper coverage by the policy for the type of accident
  • Lapsed coverage
  • Missed filing deadline
  • Improper party filing the claim
  • Damages exceeding policy limits
  • Questions of fault or responsibility for the accident

In Florida, no-fault insurance law requires the victim to file first with his or her own insurance company. Failure to do so may lead to a rejection of the claim by the insurance company.

Depending on the reasons the insurance company gives for rejecting the claim, the victim may wish to file an appeal with the company. This is often the first step in documenting the process of trying to work with the insurance company before taking legal action. Be sure to follow the company’s procedure for filing an appeal, attaching all supporting documents to the form and submitting it to the proper department.

Once the appeal is filed, the victim should receive correspondence from the insurance company documenting the appeals process. The victim may be asked to submit further documentation or evidence in support of the claim. Eventually, the insurance company will make a ruling and either pay the claim in full or in part or reject it outright with an explanation of the decision.

If a claim is rejected on appeal, the victim still has the option of filing a lawsuit against the insurance company to have the case heard in court. Throughout this process, a personal injury attorney may be able to help the victim handle both the appeal and the aftermath.

Handling a Claim Denial

Many people are uncomfortable with handling a claim denial alone. This is particularly true when the victim is seriously injured or is still suffering from the effects of the accident. If the victim needs advice, counsel or help, a personal injury attorney may be able to provide support. In some cases, retaining a personal injury attorney sends a strong message to the insurance company that the victim is taking the claim seriously and will not be deterred from pursuing legal action.