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What Do I Do If The Other Driver’s Insurance Company Denies My Claim?

Delayed Banned Cancelled Denied Stamp Label Mark ConceptWhen you’ve been injured in an accident that was the fault of another driver, their insurance company is responsible for the damages. However, insurance companies are in the business of making money and not paying claims. They will use a variety of tricks to get out of paying a fair claim. If you’ve filed a claim against another driver’s insurance and they’ve denied you, here’s what you can do.

Reasons An Insurance Company May Deny Your Claim


First, you’ll need to understand why you’ve been denied. There are a couple of reasons a car insurance company will deny a claim:

The Policy Has Lapsed: If the other party has not been paying their premiums and their insurance lapsed, they are not covered. The insurance company will also often use late payments to justify a denial based on a lapse.

Exclusions On The Policy: Insurance policies have a series of exclusions. Most of these fall under “acts of God.” Acts of God are considered uncontrollable variables like extreme weather. Insurance companies may deny your claim if they think they have a case for an exclusion denial.

Failure To Notify An Accident In Time: Insurance companies and state laws provide a lot of rules on the deadlines for claims. The best way to avoid this is to file your claim immediately with the insurance company.

They Don’t Believe You: Insurance companies will often deny a claim because they think it lacks merit. Even if your claim is legitimate, you may still face this kind of denial because they don’t want to pay.

No matter the reason for the denial, often times the real reason is that insurance companies are trying to get out of paying you. Some insurance comes will deny a legitimate claim hoping it will frustrate and confuse you or you’ll believe their denial is legitimate. If your claim has been denied, no matter the reason, don’t just automatically accept the ruling. Speak to an attorney to make sure that their denial is legitimate.

What To Do When You Receive A Denial


The first thing you will need to do after denying a claim is to hire an attorney. You’ll need an attorney that specializes in personal injury and car accidents in your state of residence. Attorneys know the law inside and out, so they will review your denial and tell you whether or not you have a case for an appeal. Insurance companies know that they can’t pull the wool over the eyes of a good attorney. So when they take over your case, you’ll be protected from their tricks.

The Steps Of A Claim Denial Appeal


Once your attorney has agreed your claim was denied for illegitimate reasons, they will begin the appeals process. Typically the steps of the appeals process are:

● Demand Letter: Depending on the circumstances of your case, your attorney’s first step will be to send the insurance company a demand letter. In the demand letter will be a formal claim that outlines the details of your accident, your injuries, and an amount you need for fair compensation. Often times a demand letter from an attorney will get an insurance company to reverse their decision.
● Formal Appeal: If the insurance company still denies your claim after the demand letter, your attorney will then take steps toward a formal appeal. During this time they will collect evidence for your claim. A formal appeal can often lead to sit down negotiations and arbitration. During this time, a fair settlement may be negotiated.
● Litigation: If after the appeals process the insurance company is still denying your claim, the next step is to take it to court. It’s rare that a case goes to court but you want to make sure that you have an attorney with litigation experience just in case.

At Shapiro, Goldman, Babboni, Fernandez, and Walsh, we have over 100 years of combined experience appealing insurance denials. We are committed to our clients and will take a claim to trial if necessary. We know all the tactics insurance companies use to get out of paying claims and we will fight to get you a fair claim. So if your claim has been denied, give us a call and we’ll help make it right.

rshapiro
Attorney M David Shapiro

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