My Insurance Company Won’t Play Ball. Now What?

An injury claim well within your coverage is being denied. Are you totally screwed? Not at all. Insurance companies will find any reason at all to deny paying out a claim, even when they tell the injured that they’re covered. Here’s how personal injury lawyers handle insurance company nonsense. 

Do Insurance Companies Deny Claims As a Tactic To Reduce Settlements?

Yes, insurance companies sometimes employ strategies to reduce payouts or outright deny car accident and injury claims as a tactic to protect their bottom line. These companies, operating under profit motives, might engage in practices hoping that claimants accept lower settlements or get discouraged from pursuing their claims. Documented instances include:

CNN Investigation (2007)

CNN found that some of the nation’s leading insurance companies, including giants like State Farm and Allstate, employed tactics to reduce claims payouts. The investigation spotlighted methods where companies would systematically deny claims or present claimants with lowball offers, betting on the notion that many would accept a reduced sum rather than contest.

“Delay, Deny, Defend” by Jay Feinman

This book delves into how some insurance companies make it standard practice to deny claims, delay the processing, or defend their position in court to reduce their payout liabilities. By doing so, they bank on claimants becoming exhausted by the process, eventually settling for less or abandoning their claims.

Such strategies underscore the importance of claimants being informed and potentially seeking legal representation when dealing with insurance companies post car accidents or injuries.

What are Some Reasons Insurance Companies Give For Denying Claims?

Insurance companies often employ a range of justifications when denying what may seem like reasonable injury or damage claims. Some of these reasons include:

Policy Exclusions

Many insurance policies incorporate specific exclusions, often buried in the fine print. These exclusions can pertain to certain types of damages or injuries. For example, some policies may not cover specific kinds of damages, or they might exclude claims based on the circumstances of the accident.

Lapsed Policies or Non-payment

An insurance claim might be denied if the policyholder failed to keep up with premium payments, resulting in a lapse in coverage when the accident occurred.

Delayed Reporting

Timeliness is critical when reporting accidents or injuries to insurance companies. They typically set a particular timeframe for reporting, and any delay can raise suspicions. Such delayed reporting can be viewed as a breach of policy terms, potentially leading to a denied claim.

Insufficient Documentation

The evidence presented in support of a claim plays a pivotal role in its acceptance. If a claimant doesn’t supply adequate documentation, like medical records, photos from the accident scene, or police reports, the insurance company can refuse the claim, citing a lack of sufficient proof.

Misrepresentation or Fraud

Honesty is paramount in insurance dealings. If an insurer identifies that a claimant provided misleading or false information, either during the policy’s purchase or in the claims process, they have grounds to deny the claim, labeling it as fraudulent or a misrepresentation.

Determination of Fault

Insurance companies meticulously assess who is at fault in an accident. If they conclude their policyholder wasn’t responsible, or deem it a case of shared fault, they may offer a reduced settlement or dismiss the claim entirely.

What Should You Do If Insurance Denies Your Claim?

If an insurance company rejects your claim after a car accident, it’s essential to take proactive measures to safeguard your rights and interests.

Review the Rejection Letter

Begin by closely examining the denial letter. Insurance companies are typically required to provide a specific reason for claim denial. Understanding this can help in formulating a response or deciding the next steps.

Gather Evidence

Ensure you have all the necessary documentation, from accident scene photos, witness testimonies, police reports, to medical records. This comprehensive evidence can reinforce the legitimacy of your claim.

Contact a Car Accident Lawyer

At this juncture, hiring a car crash lawyer in Chicago becomes pivotal. An experienced car accident attorney can evaluate the merit of your claim, advise you on the best course of action, and help navigate the complexities of insurance policies.

Lawyers play a crucial role in negotiating with insurance companies. They can challenge the rejection by presenting compelling evidence, ensuring the insurer pays for the damages and medical bills. Additionally, if you’re burdened with hefty medical bills, a skilled attorney can negotiate with healthcare providers, potentially reducing the amounts you owe. Attorneys very often sue insurance companies after claim denials.

In essence, while a claim rejection can be disheartening, it’s not the end of the road. With the right legal guidance and a thorough approach, you can challenge the decision and pursue the compensation you deserve.