Written by attorney Sean P DuBois

What to Do When Your Insurance Claim Has Been Denied

A Claim Denied Can mean Financial Hardship

If you've been in an accident, you know that damages to your car, medical bills, and time off work can all add up to being a huge financial burden. But you're depending on your insurance company to pay your bills. So what if they don't? What if they deny your claim? You could be facing a long road to justice and fair compensation.

Why Did They Deny My Claim?

There are several reasons they might have denied your claim. But you need to remember - insurance companies make more profit if they pay less toward insurance claims. This doesn't necessarily mean the adjuster is dishonest (though it wouldn't surprise me), but it does mean they are looking for any small reason to deny your claim, no matter how trivial.

Common Reasons:

  • You do not have the kind of coverage needed for the claim you've submitted. Check your policy - you might have liability insurance, but not collision which means they do not have to pay damages to your car if you were at fault.
  • You made an uninsured motorist claim with your own insurance, but the other person was actually insured (in which case you need to file a claim with that person's insurance).
  • You are not named on the policy. You have been driving someone else's car.
  • You forgot to pay the premium on time. There is usually a grace period, but once this expires, the insurance company doesn't have to help you.
  • The amount of your claim exceeds policy limits. Normally, they will pay policy limits, and you will have to face paying for the excess damages, but sometimes they deny the whole claim.
  • You bought a new car and did not inform the insurance company on time.

What to Do Now:

Write to the insurance company and explain why you think your claim is valid. Send documentation, including medical bills, car repair invoices, or even pay stubs from checks you wrote to the insurance company - anything you feel might prove that your claim is reasonable and their denial is not. If they still refuse, you have several options:

  1. Appeal the company's denial with your state insurance commision.
  2. File a bad faith claim against the insurance company.
  3. File a suit against the responsible driver.

For the last two, it can be helpful to have a personal injury attorney, but if your claim has been denied, do not despair- you have options.

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