It is not uncommon for automobile insurance companies to deny accident claims. A claimant may receive a denial if the company believes the driver could have avoided the accident, if nobody suffered an injury at the time of the accident, or if medical records do not indicate an injury or pain. Claim denials can be frustrating and stressful, especially if you are dealing with hefty medical bills and missed days at work. Here are a few options you may have after a car insurance claim denial.
Understand the Reason for Denial
The first step in fighting against a claim denial is to understand exactly why your insurance company denied the claim in the first place. Typically, you will receive a letter from your auto insurance company telling you it has denied your claim and giving a specific explanation. Common reasons for claim denials include:
- You caused the accident or could have avoided the accident
- You did not seek medical treatment immediately after your accident
- Your policy does not include coverage for your type of claim
- You currently have a lapse in coverage for failure to renew or pay your bill
- You purchased a new vehicle without telling your insurance company
- The damages in your claim exceed your policy limit
If the insurance company’s explanation does not make sense to you, call your insurance agent and ask the company to clarify. For example, if your letter states that you have a lapse in coverage but you know for a fact you paid your last bill, the denial may be due to a simple clerical error. It is always wise to talk to your insurer over the phone after receiving a claims letter if you need to clear anything up or just to verify that you received a valid claim. It is not uncommon for a company to process a claim incorrectly.
Dispute the Claim
One option you may have after a claim denial is to dispute the insurance company’s response. If you decide to dispute your claim denial on the grounds of misinformation in your original claim, send corrections or proper documentation to your insurer. For example, if you have medical documentation that proves you did in fact seek treatment right after a crash, you may send this directly to your insurer. The insurance company may be willing to negotiate if you send in corrections.
You may also contact the California State Insurance Commissioner for assistance. The commissioner is in charge of ensuring insurance company regulation. Be aware, however, that state commissioners receive thousands of complaints every year. Your complaint may never lead to a resolution of your denied insurance claim. If the commissioner does respond and send a letter to your insurance company, your company might write back with the same denial. If there are significant expenses in medical bills, serious pain and suffering, or major property damage at stake, it is wise to hire an attorney to deal with your insurance company.
Bad Faith Insurance Company Cases
It is possible that you are dealing with a bad faith insurance company, if you received a claim denial you believe is unfounded or unfair. Your company may be failing to fulfill its end of your policy contract or purposely interpreting vague and ambiguous terms in the contract in a way that bars you from coverage. Unfortunately, bad faith insurance companies get away with unfairly minimizing or denying compensation to claimants every day.
Involving a professional attorney in these situations can lead to a bad faith lawsuit and the potential to receive compensation for your damages. If speaking with your insurance company and/or state commissioner doesn’t resolve your claim, contact a denial of insurance attorney for help.