The expectation after filing an insurance claim is that the driver or passengers will receive compensation for the accident to help cover medical bills and other related expenses. However, not all claims are approved. It is possible the claim will be initially denied by the insurance company. This doesn’t mean the victim is unable to get compensation, but it can be harder. It’s important to take the right steps following a denial to try to get compensation for the accident.

Read Through the Claim Denial Letter Carefully

It is required for insurance companies to provide an explanation when your insurer denies your claim. The victim of the accident will want to make sure they read through the claim denial letter carefully, as this explains why the claim was denied and will be helpful in determining the next steps to take. In most cases, the denial can be appealed, so the victim will want to make sure they work on gathering the evidence needed to file the appeal and have a chance at the denial being rescinded.

Why Are Claims Denied?

There are numerous situations when an insurance claim can be denied. This includes the following.

• Policy Excludes Certain Situations – Most insurance policies will have exclusions, which can include driving under the influence, a driver who is not insured on the policy causing the accident, or using a personal vehicle for commercial use. These will result in an immediate denial of the claim.
• Insurance Coverage Has Lapsed – If the policy has lapsed due to non-payment, it’s likely that the claim will be denied. Some companies do offer a grace period, so catching up on payments can allow the appeal to be successful.
• Delay in Reporting an Accident to Insurance – There is a limited amount of time to report the accident to the insurance company. If the claim is made outside of this limit, it can be denied. Proving extenuating circumstances may be necessary to open a claim.
• Lack of Evidence of the Accident – If there isn’t enough evidence of how the accident occurred or what funds are needed to provide compensation to the victims, the insurance company may decide to deny the claim.
• Potential Fraud in Claim – If there is any suspicion of fraud, insurance companies will automatically deny the claim. Providing evidence can help clear up this issue.

Gather Documentation and Evidence

The victim of the accident will want to make sure they gather the evidence needed to show that the claim should be approved. Once they do this, they can write a formal appeal letter to the insurance company asking for the claim to be reopened. Evidence that can help with this might include bank statements showing payments were made, information showing why there was a delay in reporting, or dash cam footage to show how the accident occurred and what happened as a result of the accident. The evidence should be sent with the formal appeal letter to the insurance company.

If you’ve been injured in a car accident and the claim was denied by your insurance company, it doesn’t mean you’re out of luck. Instead, you’ll want to make sure you take the right steps to file an appeal and request that compensation be provided. It is a good idea to speak with a lawyer after the denial to ensure all steps following it are done correctly and to have a better chance of the appeal being successful.