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What to Do if Your Insurance Claim Is Denied

What to Do if Your Insurance Claim Is Denied

Were you hurt in an accident? You are likely facing a series of unexpected challenges, including medical expenses, lost wages, property damage, pain and suffering, and more. The last thing you might expect is a denial notice from your insurance provider.

When you file an insurance claim for an injury, your insurance company may do everything in its power to pay you as little as possible without breaching the terms of your contract. If your provider has denied your claim, know that this is not the end of the road—you do have options.

Is Disputing the Denial in Your Best Interests?

When you receive the denial notice, it will outline the reasoning behind your insurer’s decision. Your first step will be to closely review this explanation—it will typically reference exclusions in fine print. However, faulty reasoning and mistakes are more common than many would believe.

Some will recommend disputing the denial by sending your insurer a written letter. This letter would cite any errors or misleading information you found in the original denial notice. However, our team at the Law Offices of James A. Welcome generally does not recommend this avenue. If you were injured in an accident and later file suit, any correspondence between you and your insurer would become discovery (i.e. part of the evidence of your case). The steps you take after an accident may make or break your personal injury lawsuit, which is why we urge you to seek counsel and representation before communicating with your insurer.

Next Steps

For many individuals whose insurers have denied their claims, the next step is litigation. In some cases (depending on your contract), you might first need to attend mediation or arbitration with an insurance representative.

Litigation may be the best course of action if:

  • Your insurer ignored your attempts to challenge the claim;
  • Your insurer breached the terms of your contract; and/or
  • Your insurer is acting in bad faith.

For example, some insurance companies will avoid accepting liability in a case by claiming that the police report was unclear, or that your version of what happened is completely different from the police report (even if this is simply not true). Your insurance company might even conduct its own independent investigation to try and prove that you have overstated the severity of your injury. In many cases, they will simply say they are only accepting a certain percentage of liability.

By taking your case to court, your attorney can expose these attempts to avoid liability and hold your insurer accountable. If all goes according to plan, you may be entitled to compensation for any additional damages you sustained because of your insurer’s bad faith or breach of contract—on top of what they owed you from your initial claim.

Why Retaining Professional Support Is Critical

From day one, an attorney can help you advocate for yourself when your insurance company has failed you. Every step of this process requires care, timeliness, and in-depth knowledge of the legal system, which is why you need a seasoned legal team with a personal dedication to your success.

At the Law Offices of James A. Welcome, our attorneys provide legal services backed by 15+ years of experience. We understand how critical it is that you obtain coverage for your injury—and, if your insurer makes this more difficult than it needs to be, we may be able to secure additional compensation on your behalf. When you get in touch with us, we can answer all your questions and address your concerns during a complimentary consultation.

You have a limited amount of time to challenge a denial and, if necessary, take your insurer to court. Call (203) 806-7922 or contact us online to get started on your case right away.

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