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What to Do if Your Insurance Claim Is Denied

Insurance Claim Denied? What's next? - Hand holding a paper that says "Claim Denied"
Stacey Martin
Stacey Martin
August 5, 2022

If you've been in a car accident, the last thing you want is for your insurance claim to be denied. Unfortunately, this happens more often than you might think. If the car insurance company denies your claim, don't panic – there are steps you can take to appeal the decision. In this article, we'll give you an overview of what to do if your insurance claim is denied.

Understanding the Reason, Your Claim Was Denied

Claim denied

The first step in appealing a denied claim is to understand why it was denied in the first place. Claims adjusters should give you a written explanation of the insurance claim denial, so be sure to request this if you don't receive it automatically.

Once you have the explanation, take some time to review it carefully. If you need help understanding the explanation letter, you should schedule a car accident consultation with an experienced auto accident attorney.

Common Reasons for Car Insurance Claim Denials

There are several reasons why your car insurance claim could be denied. Here are some of the most common:

  1. Your policy doesn't cover the requested damages
  2. You didn't file a police report
  3. You didn't file a claim within the required time frame
  4. You didn't provide enough evidence
  5. You were accused of violating state laws at the time of the accident

Sometimes, the reason for an insurance claim denial is simply a misunderstanding. For example, you may have mistakenly thought your policy covered property damage. In other cases, the denial may be legitimate. For instance, if you didn't file a police report after the accident, it may be difficult to prove that the accident occurred.

Know the Tactics Insurance Companies Often Use to Deny a Claim

In some cases, insurance companies may use tactics to try to get out of paying a perfectly valid claim. These tactics might include:

Requesting a Recorded Statement

This is one of the most common ways insurers try to trip up claimants. They will call you and ask you to give a recorded statement about the accident. Anything you say could then be used against you to deny your claim.

Requesting Access to Your Entire Medical History

Another common tactic is for the auto insurance company to request access to your full medical history, not just records related to the accident. They will then use anything in your history to try to deny your claim.

Requesting an Independent Medical Exam

Doctor checking on a patient

The insurer may also try to deny your claim by requesting an independent medical exam. This is a second opinion from a doctor of their choosing. The problem is that these doctors often work for the insurance carrier and are not truly independent. As such, they may give a biased opinion that is not in your favor.

Delaying the Claims Process

Another possible tactic is to simply delay the claims process. They may do this by continually requesting more information or taking excessive time to review your claim. The goal is to drag out the process, so you get frustrated and give up.

Lowballing Your Settlement Offer

If the auto insurance company does decide to pay your claim, they may lowball you on the settlement offer. They might consider your damages, but they will try to give you much less than you are owed.

It's important to be aware of these tactics, so you can identify them if they are used against you. If so, do not comply with their requests. You should seriously consider getting legal assistance to move forward with your claim.

Consider an Appeal

If you think your claim was denied unfairly, you should start gathering more evidence to support your case. This might include police reports, medical records and bills, and reports from witnesses.

If you have additional evidence to support your claim, the next step is to file an appeal with the auto insurance company. In most cases, you'll need to submit a formal written request for an appeal along with any supporting evidence you have.

You may also want to consider reporting the denial to the state insurance commissioner if you believe it was in bad faith.

Consult With an Experienced Auto Accident Attorney

gavel and a car

Before you file your appeal, you should consider whether you want to hire an attorney. While it's always best to consult with an attorney immediately after an accident, it's never too late to seek legal assistance.

Hiring an attorney is a vital step in the appeals process. An attorney can help you gather additional evidence, file your appeal, and negotiate with the insurance carrier on your behalf. If necessary, they can also file a lawsuit against the insurance company.

The team at CarAccidents.com can help you determine what to do if your insurance claim is denied. If you have been injured in a car accident in the Las Vegas area, allow us to review your case by scheduling a free consultation today.