Your Legal Options When A Car Accident Claim is Denied

In the best-case scenario following a car accident, the insurance claim filed by you and your attorney is accepted and you can receive financial compensation for your damages.  However, unfortunately, it sometimes doesn’t go this smoothly.  

Just because your claim was denied doesn’t mean all hope is lost.  You still have options for pursuing recovery for your injuries and damages.  Here’s what you can do if your car accident claim gets denied and how a personal injury lawyer from our firm can help.

Why Was My Claim Denied?

The most important detail following a claim denial is the why.  Knowing why the insurance company denied your claim will help you accurately determine whether you can dispute the denial.  There are a number of reasons for denied insurance claims.  A few common ones include:

• Your insurance policy doesn’t provide coverage for your type of claim—for example, if your accident falls under collision coverage but your policy only provides liability coverage
• Lapsed coverage due to late premium payments.
• Simple errors by the insurance company, such as an incorrectly-entered code or a claim sent to the wrong insurer.
• The insurance company won’t cover the full damages claim because they exceed policy limits.
• Lack of coverage under the policy, such as a teenager excluded from their parents’ policy.
• The claim is for a new car that you didn’t add to your policy within a certain timeframe.
• You made an uninsured motorist accident claim when the other party actually had insurance.

Some reasons for denial are legitimate while others may have reason for dispute.  You’ll want to review the insurance company’s reasons for denial carefully and compare them with the documentation you included with your claim.  If the reason given for your denial doesn’t reflect the truth of your claim, you have options for disputing the decision. 

What Are My Legal Options When a Car Accident Claim is Denied?

If your claim is denied, you have three main legal options for disputing it.  They are:

1. Writing a letter to your insurance company about the mistake.

Your insurance company should provide instructions for how to appeal a claim denial (usually part of a denial notice on the back of your insurance card). 

You’ll need to provide the insurer with documentation to support your dispute of their decision.  Be specific about why your evidence contradicts their decision to deny your claim.  This is where you’ll want to include as much relevant information as possible to support your case, including pictures of the accident, injuries and damages suffered, any medical records, tests, medications, and doctor’s notes, police reports, and more.  Connect each of these pieces of evidence to your case against the company’s denial.

Insurance providers are required to make a decision about your appeal within strict deadlines after they receive it:

• 60 days for medical treatment you’ve received
• 30 days for medical treatment you have yet to receive
• 72 hours if the appeal is for an urgent care claim

2. Filing a bad faith insurance claim again the insurance company.

This may be an option if you feel the company is bullying you or acting in bad faith, breaching contract, or violating your state’s insurance code.  You will need the help of a car accident lawyer to help you determine what is considered bad faith and pursue this type of legal action.

Note: insurance companies are required to act in good faith when dealing with any car accident claims.  Just because you appeal a claim doesn’t mean they will reverse their decision. However, they should be open to your dispute if you support your argument with evidence.  If they don’t settle a claim promptly or deny it without good reason, they could be in violation of state laws and be acting in bad faith. 

Keep notes of any conversations you have with the insurance company during this process, including names and direct numbers of representatives you speak to and when the conversations occurred.

3. Filing a lawsuit against the other party.

If your insurance claim denial isn’t successful, you may still file a lawsuit against the other party in the accident if they were responsible.  Speak with your attorney about whether this is an option in your case.

In most cases, you will NOT have to proceed all the way to trial.  Usually, once you get a lawyer, they can build a case and negotiate for you without going to court.  But, if needed, court is the final step. 

Get Help for a Denied Car Accident Claim

If your insurance claim for a car accident was denied, you have options.  The car accident lawyers at John Foy & Associates are here to help you with the next steps.  Contact us today at 404-400-4000 or fill out the form to your right for a FREE consultation to discuss your case.