What Happens If Your Insurance Claim is Denied?

Perenich, Caulfield, Avril & Noyes Personal Injury Lawyers | Insurance Claims

What Happens If Your Insurance Claim is Denied?

If your insurance claim is denied, you may feel helpless, but taking action can make all the difference. Simply accepting the denial can leave you without the compensation you deserve. However, by understanding your rights and the appeals process, you can challenge the denial effectively. If you’re unsure how to proceed, hiring an experienced attorney can provide the guidance and support you need. Below is a guide on how to dispute a denied claim and protect your interests.

Reasons Why an Insurance Company Might Deny Your Claim

Following is a list of just a few of the most common reasons why an insurance company might deny your claim:

  • Failure to notify the insurance company within a reasonable time after the accident: You generally have 30 days after the accident to notify the insurance company of your accident and the resulting injuries. Please note that this deadline is different from the five-year statute of limitations deadline for filing a lawsuit. Don’t confuse the two. Also, check your policy for any other applicable deadlines.
  • Lack of evidence: You need to collect all the evidence you can to back up your claim. If you suffer an injury from a driver who was texting while driving, for example, you might need to obtain records from the cell phone service provider. If your evidence doesn’t add up to the “preponderance of the evidence” (more likely than not) standard, your claim will probably fail.
  • Delay in seeking medical treatment: Some medical conditions, such as head injuries and soft tissue injuries, can take time to generate symptoms. Don’t let this tempt you into skipping medical treatment. Medical records are among the most powerful sources of evidence in existence. If you delay seeking medical treatment, the opposing party can claim that the accident is not what caused your injuries. 
  • Disputed liability: The at-fault party to the accident might claim that the accident was partly or completely your fault. This state of affairs can greatly complicate your claim. If successful, it could reduce the amount of your claim or even defeat it altogether.
  • Policy exclusions: The insurance policy you’re claiming against may not cover the type of losses for which you are claiming compensation, or it may not cover the full amount of your claim.

Understanding the reasons why an insurance company might deny your claim is crucial to navigating the process and protecting your rights. 

Steps to Take if Your Claim is Denied

If the insurance company denies your claim, consider taking the following actions:

  • Demand a written explanation for the denial: The insurance company owes you this. If their reasons for denial are unconvincing, falsified, or flimsy, you can use them as evidence against the insurance company in court. If the adjuster refuses to provide a written explanation, you will need to prepare and send a letter to the adjuster confirming (a) the denial of your claim and (b) the refusal to explain the reasons for the denial in writing. You can also use this as evidence in court.
  • Negotiate with the insurance company: Reaching a settlement of a major claim without negotiation is nearly impossible. Of course, they might refuse to negotiate with you, which will leave you with no other choice but to go to court. If you do end up negotiating, let your lawyer do the negotiating for you. If all else fails, try to mediate your claim.
  • File a lawsuit: A lawsuit carries far more clout than an insurance claim does. Filing a lawsuit will force the insurance company to take you seriously. It will also beat the statute of limitations deadline (usually two years for a Florida personal injury claim), and it will get both sides access to the court-supervised pretrial discovery evidence-gathering process. Keep in mind that you might have to exhaust the insurance company’s internal appeals process before you can file a lawsuit.
  • Draft and sign a settlement and release agreement: If pretrial discovery goes well enough, you might have enough evidence to force a settlement on your terms. A settlement and release agreement obligates you to permanently drop your claim against the opposing party in exchange for a certain amount of money.

If your insurance claim is denied, taking the right steps—such as demanding a written explanation, negotiating with the insurer, or filing a lawsuit—can help you protect your interests and increase your chances of obtaining a fair resolution. 

It’s Never Too Soon to Talk to a Lawyer

Most St. Petersburg, Florida, personal injury law firms, including Perenich, Caulfield, Avril & Noyes Personal Injury Lawyers, offer free initial consultations. We have fought cases all the way to the US Supreme Court, and we have won many sizeable victories for our clients. Contact our team today to schedule a free consultation with a St. Petersburg personal injury lawyer.

Contact the Pinellas County Personal Injury Law Firm Of Perenich, Caulfield, Avril & Noyes Personal Injury Lawyers for Help

For more information, please contact the Clearwater and St. Petersburg personal injury law firm of Perenich, Caulfield, Avril & Noyes Personal Injury Lawyers at the nearest location to schedule a free consultation today.

We serve Pinellas County and its surrounding areas:

Perenich, Caulfield, Avril & Noyes Personal Injury Lawyers – Clearwater
1875 N Belcher Rd. STE 201,
Clearwater, FL 33765
(727) 796-8282

Perenich, Caulfield, Avril & Noyes Personal Injury Lawyers – St. Petersburg
2560 1st Ave S,
St. Petersburg, FL 33712
(727) 349-1728