Was your personal injury claim denied? When you’re dealing with injuries and mounting medical bills, the last thing you need is a rejected insurance claim. The path forward may feel overwhelming and frustrating, but understanding why claims are denied and knowing your options can help you navigate this challenging situation.
As personal injury attorneys in San Jose, Hann Law Firm understands this difficult position. This guide will explain what to do when your personal injury claim is denied.
Understanding Why Insurance Companies Deny Claims
Insurance companies often look for reasons to minimize payouts or deny claims entirely. Their primary goal is profitability, and paying claims works against this objective. Recognizing the common reasons for denial can help you better prepare your response.
Common grounds for insurance claim denials include:
- Insufficient evidence: The insurer might claim you haven’t provided enough documentation to prove fault or the extent of your injuries.
- Pre-existing conditions: They might argue that your injuries existed before the accident occurred.
- Policy coverage limits: The company might state that the accident type or location isn’t covered under your policy terms.
- Delayed medical treatments: They might suggest that the gap between your accident and medical care indicates that your injuries weren’t serious. They could also argue that your injuries worsened because you failed to seek prompt treatment.
- Fault disputes: The insurer might claim that you were partially or entirely responsible for the incident.
Steps To Take After a Denial
Was your personal injury claim denied? If so, don’t panic. This isn’t necessarily the end of your case.
Take methodical steps to challenge the decision and protect your rights:
- Request a detailed written explanation immediately. This document should specify which policy provisions the insurer is citing as grounds for denial.
- Review this explanation carefully and compare it to your policy language. Look for any discrepancies or misinterpretations that might have led to the denial.
- Document all communications with the insurance company. Keep records of phone calls, emails, and letters exchanged regarding your claim.
Pursuing the Claim Appeal Process
Was your personal injury claim denied? If so, it’s time to consider an appeal. This allows you to address their concerns and provide additional evidence.
Submit a well-documented appeal letter addressing each reason for denial with supporting evidence. Personal injury cases often require substantial documentation to overcome denials.
Include any additional documentation that strengthens your case, such as:
- Medical records: Medical records provide detailed information about your injuries and document the full extent of treatment you have undergone.
- Professional opinions: Opinions from medical professionals can establish a clear causal link between the accident and your specific injuries.
- Witness statements: Witness statements offer third-party accounts of the incident that can help verify your version of events.
- Photographs: Photographs serve as visual evidence of your injuries or the accident scene that can substantiate your claim.
- Accident reports: Accident reports provide official documentation of the incident from authorities who responded to the scene.
Consider seeking legal representation before filing your appeal. An attorney can identify potential weaknesses in the insurance company’s position and help strengthen your appeal.
How Hann Law Firm Can Assist
Was your personal injury claim denied? We can review your case and discuss potential paths forward.
At Hann Law Firm, our team is knowledgeable about insurance company practices and can help you understand your options. We thoroughly review claims, help gather appropriate evidence, and work diligently on behalf of our clients.
Contact Hann Law Firm at (408) 755-3498 for guidance through this challenging time. Our San Jose team is committed to working hard for you throughout the process.
