How To Understand And Fight An Auto Insurance Claim Denial

Blog

It happens to everyone - a simple mistake, either by victim or perpetrator, and your car is destroyed, languishing at the towing company while your insurance is processed. Unfortunately, even some of the most clear-cut insurance claims can be denied for archaic or unclear reasons.

Whether done through an accident attorney or through private channels, fighting an auto accident insurance claim is often worth the time, effort, and money.

Understand Why Your Claim Was Denied

Often, the difference between a cut and dry case and one that can languish in the courts for years is simply understanding why the insurance claim was denied in the first place. While some circumstances, such as not having comprehension coverage, are very clearly not going to be overturned, others may be easily dealt with. Understanding your particular situation is very important.

Filing Issues and Errors

Many insurance claims are rejected due to issues with filing or errors on the claim forms. These are by far the easiest denials to fight.

For example, if the person you were in an accident with claimed they were uninsured, you likely filed an Uninsured Motorist Claim. If that person is then found to have insurance, your claim would be denied, but more often than not, you would have to refile independently of the original filing.

You Are "At-Fault"

One of the more difficult rejections to fight, insurance claims can be denied if you are found to be "at-fault" in the accident. These judgments can be contested in court, however, and it is advised that you seek an auto-accident attorney (such as one from Kuzyk Law).

A finding as such by your insurance company doesn't just have economic implications - evidence discovered during the investigation could be used against if if subpoenaed in a case concerning the accident, altering the outcome dramatically.

Request a copy of the report, and pour over it - highlight any inconsistencies, misleading evidence, or outright fabrications from the other party. Return a copy of your findings to your company, and request they review the filing. If they refuse to do so, do not be afraid to file a suit - being found "at-fault" could have significant and lasting effects on your finances and your future ability to get insurance.

Your Coverage Lapsed

Often considered a "clear-cut" situation, if your insurance lapsed relatively close to when you got into the accident, you may be able to get coverage from your company. If you have been a long-term customer, have already purchased insurance, or have a long-standing record with the company, it is possible that you could request the coverage be extended for a short duration.

While this is hard to fight and should be considered a "long-shot", do not be afraid to request it - you have nothing to lose, and a whole lot to gain.

File a Challenge

Once you've understood why your claim was denied, you can begin the long process of challenging the denial. This can be done through several avenues, both directly through the company and throughout third parties.

File an Appeal

Most insurance companies will allow you to file appeals to denied claims. These appeals are typically processed through the standard means that the original claim was filed through, but takes the supplemental evidence provided as a secondary source of information.

Keep in mind that the original decision of the insurance company has heavy weight when it comes to appeals - more often than not, unless the evidence provided is conclusive, the claim will likely be denied again.

Send a Letter

Sometimes, an appeal doesn't have to be filed if you can send a letter of addendum to your company. This letter will state that the case was closed prematurely, and that new evidence can change the outcome. This is considered an 'informal" dispute, so don't expect too much unless your company has a specific route for filing an addendum.

Take Them to Court

As a last resort, you can opt to take your insurance company to court due to negligent filing practices or misjudgment. When going through this process, you can request a summary judgement, which is when the court will either declare you "at fault" or "not at fault", thus forcing your insurance company's hand.

Keep in mind that this will disrupt your standing with your company, so if you decide to go down this road, prepare to find a new insurance provider, lose your long-term coverage discount, and more.

Share

24 February 2015