If you were injured in an accident, you may have filed an insurance claim to recover compensation for your medical expenses, lost wages, and other damages. You reasonably expected the insurance company to treat you fairly, investigate the accident, and find in your favor. However, if the insurance company has denied your claim, you might be confused about your legal rights and options. Here is what you need to know about this pressing issue.
Common Reasons Insurance Companies Deny Claims
Insurance companies are for-profit businesses that make millions of dollars every year by raking in more money from premiums than they pay out in claims. It’s important to keep this in mind because they will use tactics to try to deny as many claims as possible to protect their bottom line. Some of the reasons they may cite for these denials may include:
- Lapsed policy – The insurance company may claim that the insurance policy had lapsed due to a failure to pay premiums or other issues.
- Policy exclusions – The insurer may cite various exclusions of the policy, such as acts of God, that mean the policy in question did not apply to the claimed losses.
- Failure to make timely notification – The insurance company may say that you were supposed to make the claim sooner for it to be covered under the policy. Some insurance contracts have a set amount of time that an insured has to notify the insurer of a possible claim for it to be covered.
- Disputed liability – The insurance company may blame you for the accident or otherwise claim that their insured was not at fault for the accident.
- No injuries – The insurance company may claim that the accident was not of sufficient force to cause the injuries you suffered, denying you were injured at all or suggesting that something else caused them.
Legal Options After a Claim Denial
If the insurance company denied your claim, you may have several options, including:
Draft a Demand Letter
The insurance company may have denied your claim, but if you involve a Carlsbad personal injury attorney in the matter, they may take the situation more seriously. A lawyer can prepare an official demand letter that details:
- The details regarding the accident
- Why the insured was legally responsible for the accident
- The damages you suffered
- Your intent to pursue litigation if the insurance company does not fairly compensate you for your injuries
The insurance company may respond by offering to settle your claim, and your lawyer may be able to negotiate a fair settlement agreement. If the insurance company continues to deny your claim, you may decide to sue in court.
File an Appeal
The insurance company may have a formal appeals process you and your Carlsbad car accident lawyer can use to fight the denial. Alternatively, your insurance contract may provide for arbitration to resolve disputes.
Make a Bad Faith Insurance Claim
In some cases, insurance companies may engage in bad faith practices. Insurance companies owe a legal duty to their customers to act fairly and honestly in dealing with their claims. If they deny a claim without a valid reason, fail to conduct an investigation, or otherwise violate their duty, they may be committing bad faith, and you may be able to make a claim against them.
Seek Legal Advice and Assistance from a Qualified Personal Injury Attorney
If your insurance claim was denied, Miller & Steele Law Firm can help. We can review your situation and explain your legal options. Call (760) 840-5221 or contact us online for a free case review.