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What If My Insurance Company Refuses to Pay My Injury Claim?

When an insurance company refuses to pay your claim, it is time for you should continue your ‘battle.’ Many people fear that it is the final and only decision, but with a skilled personal injury attorney in Springdale, you will fight back and continue your process until you get your claim.

When a claim investigator formally declines to pay for your injuries or damages, they have already collected evidence to support their decision in court. Sometimes, the investigator is open to negotiation. Once the investigator formalizes your denied claim, they expect you to give up and accept your faith.

Reasons for Denied Claims

Policy Excludes the Insurance

Some types of injuries are excluded from insurance policies on purpose. There are many cases where insurers deny the claim because of a technicality that is not explained in detail in the policy.

Lapse of Coverage

Insurance policyholders forget to renew various types of coverage, so the coverage is not automatically extended or replaced in most cases. If this is your case, then your injuries might not be covered because of the expiration date.

Incorrect Information or Incomplete Claim

If you are submitting the claim and enter incorrect information, you may fail to comply with claim submission requirements. These small mistakes end with a claim denial. Be sure to make a thorough investigation within a claim denial.

You Didn’t Get Immediate Treatment

The insurance company may refuse to pay you a claim because you failed to seek immediate medical treatment, even if you were injured. Also, you may fail to get the claim if you don’t have medical records, so the insurers will assume that there was no injury.

Previous Health Issues

The insurance company may claim that you were not injured on the date of the alleged accident, but that your injuries are a result of some pre-existing injury or health issue.

Failure to Mitigate Injury

Injury claims are denied if the injured party fails to avoid the failure to act reasonably to avoid making it worse. If you were injured in an accident but waited for a month to get medical treatment, you have failed to mitigate the injury.

What to Do if the Insurance Company Refuses to Pay Your Claim

If the insurance company denies your claim, make sure you study the insurance policy first and then contact the insurance company. If the insurance company does not provide a valid explanation of the denial and you were injured, call a personal injury attorney.

You can’t fight the insurance company that denied your claim if you don’t understand why they did that in the first place. You will have to get more information. You can educate yourself or ask your personal injury attorney for answers.

Usually, the claim seeker will get a letter with an explanation for the claim denial. If you didn’t receive a written explanation, call the claim representative who denied your claim and ask for a letter with an explanation of why you did not get it. If you did get a denial letter and you lost it, ask for another copy. These letters might not be very comprehensive since they contain legal phrases and insurance jargon; ask your attorney to help you understand the letter.

If you are facing the decision of your insurance to deny your claim, don’t worry and remain calm. Don’t let this decision affect you in any way. This is not the final act. The insurers might think that you will accept their decision; it is time to act smart and use what you can to continue your process.

First of all, make sure you read your policy, do research, and consult with people who were in the same situation.

The next thing you should do is get legal help from a personal injury attorney. Your lawyer should be someone who has experience in such cases.

Allow your lawyer to educate you and counsel you for your next step.

The compensation claim is very important for victims of motor accidents because now more than ever, they need the money to make ends meet. They face high and frequent medical fees, can’t attend work, and are losing wages and also have to face other expenses related to the injury.

Our team at Jason M. Hatfield, P.A. has over twenty years of experience in such cases. We know how devastating it can be for an accident victim to remain without their claim.

Call our office today. Allow us to be there for you.

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