What to Do When the Insurance Company Is Refusing to Pay Claims

Posted by Impact Legal | Nov 19, 2021 | 0 Comments

Make no mistake, if the insurance company is refusing to pay your car accident claim, you have a right to take legal action. In fact, we recommend it. If an insurance company has denied your claim for no good reason, they may be operating in bad faith insurance. If that's the case, contacting an insurance claim lawyer in Arizona or New Mexico is advisable. 

In this article, we'll outline the steps to take if an insurance company has denied your claim. We'll also discuss signs that an insurance company is operating in bad faith. If you've received a denial, schedule a free consultation with our insurance attorneys today, and we'll review the facts of your case. 

Why Did the Insurance Company Deny Your Claim?

The first step in fighting the denial decision is understanding why it was made in the first place. The reason for the denial can help you determine whether the decision was a mistake, a misunderstanding, legitimate, or made under bad faith. A few common reasons that an insurance claim may have been denied are:

  1. A lack of coverage exists - Insurance can be complicated. Often claimants believe they have insurance coverage that they end up not having as specified in some random fine print somewhere within the policy.
  2. Coverage has expired or lapsed - This tends to happen in the case of automatic renewals. Sometimes a type of coverage may renew and another type may not. Make sure you're very clear on your policy renewal when you review it. 
  3. The insurance company was not informed within a specific timeframe - After an accident, the time clock starts on many fronts. There are several deadlines you want to be aware of, which your lawyer will help you keep track of. Contacting the insurance company in time is a big deadline to pay attention to after an accident. 
  4. You failed to get treated within a specific timeframe - Another deadline you'll want to watch is when you seek treatment for your injuries. Waiting too late for treatment is a big mistake. Another mistake is not seeking consistent treatment if you need it. 
  5. The claim was filed with mistakes or errors - When you're submitting a claim, make sure you double-check your work. Mistakes can cause unnecessary delays and denials. These mistakes can range from misspellings, administration errors, noncompliance on filing requirements, etc. If you catch a mistake after submission, make sure to contact the company as soon as possible to try to avoid any negative consequences.    
  6. The claim contained fraudulent information - False or exaggerated claims can not only cause an insurance claim rejection, but they can also get you into a lot of legal trouble, both criminal and civil. 
  7. Bad faith insurance practice - Bad faith insurance happens when an insurance provider fails to uphold an obligation to the policyholder. Bad faith may be to blame if a provider is withholding payment on a legitimate claim, delaying the process by an unreasonable amount of time, etc. If you believe this has happened to you, don't delay! Talk to an insurance lawyer as soon as possible. 

Appeal the Decision with the Insurance Company

To understand why your car accident claim has been denied, carefully review the denial letter from the insurance company. Once you're aware of the decision and why it was made, you can seek help from an insurance claim lawyer to appeal the denial. The initial step to appeal is to gather the appropriate and relevant evidence, on which your lawyer will guide and advise you. Some of the following details may play an evidentiary role in your appeals process:

  • Medical records, including x-rays, MRIs, doctor reports, etc
  • Official police reports
  • Photographs of the accident scene, damaged vehicles, injuries, etc
  • Eyewitness statements 
  • Medical bills, including initial emergency room costs, recurring doctor visits, prescriptions, etc

Depending on the specifics of your case, other forms of evidence may be necessary, including expert witnesses, reconstructed accident scenes, traffic data, black-box data, and more. Your accident lawyer will help you collect the evidence needed in your insurance claim denial appeal. 

Once the evidence is collected, it's time to file the insurance claim denial appeal. This can typically be found on the insurance company's website, but, if not, you may have to call them. Using the proper appeals form is usually advised rather than drafting your own appeal letter. Once you've filled in all of the boxes, be sure to double-check your work. Mistakes, misinformation, and errors can cause a claim to be rejected. 

The appeals process can be quite lengthy. Insurance companies count on the length and tedium wearing claimants down so they take a smaller settlement out of desperation or drop the process entirely. Don't do this. Be patient, and don't let the insurance provider take advantage of you. You deserve a fair and appropriate settlement.  

What to Do If Your Appeal Is Denied

If your appeal is denied, you can still take legal action, especially if the provider is operating in bad faith. The law outlines that an insurance provider must act in good faith, abiding by the terms of your policy and meeting all responsibilities to you. If an insurance company has failed to do this, they are practicing bad faith insurance, and they can be held legally responsible. 

If you believe your insurance company is acting in bad faith, call Impact Legal today. Some signs that bad faith is happening include:

  1. Huge delays in the investigation of your insurance claim 
  2. Inadequate investigation of your insurance claim 
  3. Lowball settlement offers 
  4. Insurance claim denials 
  5. Taking an enormous amount of time to approve your claim

If you've been a victim of any of the above, bad faith insurance may be the cause. Remember that you are legally protected. Don't give up on getting the settlement you deserve and need. 

Don't Fight This Fight Alone

Impact Legal is your advocate against the insurance company. If you've been given the runaround, don't wait any longer to contact our insurance claims lawyers in Arizona and New Mexico. We will fight for your right to a fair and appropriate insurance settlement. If you've been denied the right to recover from your injuries, you have legal options. The first step is scheduling a free consultation with us by calling 602-345-1818 or filling out our free online consultation form here. Remember that the insurance provider is hoping you drop out of the process – we're here to tell you that you don't have to do that. 

About the Author

Impact Legal

About Our Personal Injury Law Firm Impact Legal was created to have an impact on the lives of those who live life to the fullest. Just because you know how to have fun on a boat, on your side-by-side, or on your dirt bike, doesn't mean you're any less hurt when accidents happen. Impact Legal is ...

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