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Why do insurance companies deny injury claims?

On Behalf of | Sep 26, 2022 | Personal Injury |

If you sustain injuries because of an auto accident, you will likely file a claim with your personal insurance company or the insurer of the party responsible for your injuries. Unfortunately, there is no guarantee that the insurer will approve your claim.

FindLaw describes a number of reasons why insurance companies deny injury claims. Depending on your circumstances, one or more of these rationales may be a possibility in your case.

Failure to take key steps

The insurance company you are dealing with may require you to perform certain actions as part of your claim. This can include submitting evidence of the crash, such as pictures of the accident or an account that details what happened at the scene. The insurer may also want the names of witnesses to the accident.

Additionally, you will likely provide medical evidence of your condition. You may supply exam results from a personal doctor, but this might not be enough. Sometimes an insurer wants an exam completed by an independent medical examiner. A failure to submit an exam if the insurer requests it could lead to a denial.

Policy loopholes

Be aware of any policy language that the insurer could use to deny your claim. Some people who file a claim with their own insurer get turned down because their coverage did not apply to their specific case. If you dispute the reason for the denial, you might be able to take up the case with the state insurance authority.

You have filed the claim too late

Be aware of time limitations to file a claim. If you wait too long following your injury to seek coverage, the insurer might deny you. In any case, look at how the appeals process works for the insurance company since you may have an option to overturn the denial and get the coverage you need.