My Claim Was Denied

People purchase insurance for peace of mind. After an accident, we trust that our insurance policies will provide the money we need to cover our losses. We also hope that if someone else harms us, their insurance company will pay the compensation we deserve. Unfortunately, insurers deny payment for legitimate injury claims far too often.

Did an insurance company deny your injury claim? If so, you have the right to feel angry and confused. But don’t lose heart. An initial denial doesn’t mean you’re out of options. You can appeal the insurance company’s decision or even take them to court if you believe that they denied your claim in bad faith. An experienced personal injury attorney can help determine what legal options are available in your case.

Why Would My Injury Claim Be Denied?

An insurance company might give you many excuses for denying a claim. Some of the most common reasons include:

• Lack of medical evidence: If you don’t provide adequate proof of your injury, you might not be able to obtain coverage.
• Delayed treatment: Most insurance companies require claimants to seek medical attention within 72 hours of an accident. The longer you wait to get treatment, the more likely the insurer will deny your claim. They might argue you sustained your injury in a separate accident.
• Clerical errors: Any mistakes on claims forms can lead to denials.
• Expired coverage: If you neglected to renew your insurance coverage, the insurance company might reject your claim.
• Injury isn’t covered: Insurance companies sometimes refuse to cover specific types of injuries. Examine your policy documents to determine if your injury is covered.
• Pre-existing condition: If you have a pre-existing condition, the insurance company could argue that your injury resulted from your condition rather than from the accident itself.

What to Do if My Personal Injury Claim Was Denied?

If the insurance company denies your claim, you might still be able to get the money you need. Here’s what to do:

• Find out why: Ask the insurance adjuster for a written explanation of why they denied your claim. When the insurance adjuster receives your letter, they might respond by making a settlement offer right away. If they don’t reply, send the insurance company a letter stating that your claim was denied and that the insurance adjuster will not disclose why. Sending a letter can also support your case if you eventually need to file a lawsuit.
• Talk with a personal injury lawyer: Insurance companies are obligated to act in good faith when dealing with claimants. If they neglected to investigate your claim properly, refused to negotiate a settlement, or rejected a legitimate claim, you could take legal action. For example, your attorney may advise you to file a third-party lawsuit against the negligent party’s insurance company. In some cases, you could be eligible to file a lawsuit – or first-party claim – with your insurer. A first-party claim may be appropriate if you were hurt in a hit-and-run accident or struck by an uninsured driver, for instance. A successful lawsuit could provide the compensation you need and deserve.

Can I Sue the Insurance Company for Denying My Claim?

It’s possible to sue the insurance company for a claim denial, but you need a lawyer to determine whether you have a valid case. You might be able to sue for:

• Breach of contract: Your insurance policy is a contract between yourself and your insurer. You could have a breach of contract lawsuit against them if they reject a legitimate claim.
• Bad faith tactics: Insurance companies are prohibited from engaging in bad faith conduct. You could potentially file a lawsuit against them if they violate their obligation to you.

Was your Sacramento injury claim denied? Don’t take no for an answer without a fight. Contact Demas Law Group, P.C., to discuss your situation with an experienced California personal injury lawyer. Our team will identify your options to pursue the compensation you need. Call or contact us for a free consultation now.