My Personal Injury Claim Was Denied: What Can I Do?
Sustaining an injury due to someone else’s negligence can be emotionally and financially devastating. This is why most people turn to insurance companies to receive compensation for their losses.
However, if your claim was denied, you might feel disappointed and unsure of what to do next. Just because your claim was denied does not necessarily mean that it will be impossible to get compensation. Our personal injury lawyer at Cameron Law can explain what you can do if your claim was denied to obtain the coverage that was paid for.
Common Reasons Insurance Companies Deny Personal Injury Claims
Insurance companies have various reasons for denying personal injury claims. Here are six of the most common ones:
- Lack of medical evidence. Insurance adjusters will want to have a clear understanding of your injury and the resulting medical expenses. You need to provide detailed and compelling medical records that document your treatment, diagnosis, and prognosis.
- Questionable cause of the injury. If the insurance adjusters cannot clearly see the link between your injuries and the accident, they will likely deny your claim.
- Pre-existing medical injuries. Your claim will be scrutinized if you had a pre-existing medical condition. Insurance companies will try to argue that your injury was related to this existing injury.
- Late reporting. Insurance companies usually have a specific window of time when accidents should be reported. In case of late reporting, they might argue that it’s hard to investigate the accident’s cause and impact.
- Policy coverage constraints. Insurance adjusters also deny claims if the policy covering the injury does not cover the incidence type of injury you sustained.
- Inadequate coverage. Your claim might be denied if the insurer thinks the coverage is insufficient to meet the medical bills and other expenses.
Depending on the reason for the denial of your claim, you can either appeal the denied claim or file a bad faith claim against the insurer.
Appealing a Denied Claim
If you receive a claim denial, there exists a chance for you to appeal the decision through a series of administrative procedures. The first step is to read the company’s decision carefully and try to understand why your claim was denied. You may then file an appeal specifying their exact reasons for denying the claim and provide any additional information or documentation to support your claim.
While an appeal can be successful, it is essential to understand that an appeal gives no guarantee that the insurer will change the initial decision. This is why you might want to work with a personal injury lawyer who can guide you through the process and maximize your chances of a successful appeal.
Filing a Bad-Faith Claim Against the Insurance Company
Insurance companies are expected to deal with clients in good faith. However, if your insurer is withholding payments or acting in bad faith, you have the option of filing a bad faith claim against them. In a bad-faith case, liability for damages is often much more extensive than in traditional personal injury cases.
Bad faith is generally a legal term that describes an insurer’s wrongdoing. If they are found guilty of such actions, the insurer may be liable for punitive damages, court damages, and attorney fees, as well as any damages for which they are responsible. According to the official website of the State Bar of Nevada, insurance companies that act in bad faith may be subject to punitive damages.
Why You Need a Personal Injury Lawyer if Your Claim Was Denied
It is always necessary to consult with an experienced attorney following an injury claim denial. Many of the factors leading to denied claims require professional legal guidance and experience. The attorney steps in to explore the specifics of your case, guides you in the appeals process, and files a bad-faith claim against the insurance company on your behalf.
Was Your Personal Injury Claim Denied? Cameron Law Can Help
The aftermath of an injury can be overwhelming, particularly when your claim is denied. It is, however, essential to pursue the compensation you deserve. A personal injury lawyer at Cameron Law can guide you through the appeal and bad faith claim processes to help you get the compensation you need. Call 702-745-4545 for a free case review.
Source:
nvbar.org/for-the-public/find-a-lawyer/lrs/insurance/
