Filing a personal injury claim is an important step for anyone trying to recover from an accident, make ends meet, and hold someone accountable for causing harm. Unfortunately, legitimate claims are sometimes denied, leaving injured people frustrated and without help when they need it most. Knowing the most common reasons for these denials can make the process less confusing and help you avoid costly mistakes as you move forward. Some of these reasons include:
Policy Exclusions
Insurance policies are packed with fine print about what situations are covered and what are not. If your injury happened during an excluded activity – such as while you were breaking the law or engaging in dangerous behaviors not covered by the policy – your claim might be turned down right away.
Failure to Prove Liability
In every claim, it’s up to the person who was hurt to show clear evidence that someone else was responsible. If you don’t have photographs, witness statements, medical records, or other proof connecting the other party to your injury, the insurer might refuse to pay.
Inadequate Medical Evidence
Getting prompt treatment and saving all your records is essential. If your medical files are missing, incomplete, or don’t clearly connect your injuries to the accident, insurance adjusters often take advantage of this and deny your claim.
Delayed Filing
Time limits for filing a claim are strict. Waiting too long after an accident or missing the insurer’s deadlines can mean a claim is automatically rejected, no matter how real your injuries are.
Pre-existing Conditions
Insurance companies frequently argue that the pain or issues you are experiencing started before the accident. Without strong documentation showing new injuries or new symptoms, they can cite your medical history as a reason not to pay.
Understanding why injury claims are commonly denied gives you a stronger foundation for preparing your case.
What to Do After Your Personal Injury Claim is Denied
If your personal injury claim has been denied, don’t panic – there are steps you can take to challenge the decision. Here’s what you should do right away:
- Review the Denial Letter: Start by reading the denial letter from your insurance company, making note of the exact reasons the claim was rejected. The language may seem technical, but understanding what’s being disputed puts you in a better position to respond.
- Contact Your Insurance Company: Reach out to your insurer directly to ask for details about the denial. Ask them to explain the rejection in plain language, and don’t hesitate to request examples of what information or evidence was missing. Sometimes claims can be revisited when new documentation is provided.
- Request a Copy of the Claim File: You have the right to see everything the insurance company used to make their decision. Requesting the entire claim file will let you review what adjusters saw, spot errors, or recognize if important documents never made it into your record.
- Contact a Personal Injury Lawyer: If you’re unsure or facing a stubborn insurer, contacting a qualified attorney can make a big difference in how your next steps unfold.
How a Personal Injury Lawyer Can Help After a Claim Denial
Once you’ve spoken with a personal injury lawyer in Louisville and have them on your case, they can take certain steps to try to help you face your denial. Here’s how they can assist:
Evaluate the Denial
An attorney will look over the reasons your claim was denied and help determine if it was proper or clearly off-base. They know which details matter most and can spot when insurance companies aren’t playing fair.
Negotiate with the Insurance Company
Lawyers often reopen communication with the insurer, presenting missing or updated evidence and pushing back against weak excuses. Their involvement alone can get your claim a second look.
File an Appeal
If the insurance company won’t budge, your lawyer can guide you through the formal appeals process. This includes gathering the right paperwork and preparing arguments that target the issues behind the original denial.
Litigation
When all else fails, the answer is to file a lawsuit against the insurance provider in court. Your lawyer manages every step – drafting legal pleadings, collecting more evidence, and representing you before a judge or jury until your dispute is resolved.
Getting denied isn’t the end, and with the help of an experienced attorney, you have a chance to turn things around. Contact us today to schedule a free consultation.