What to Do When Your Insurance Company Denies Your Claim

If you have been injured or suffered property damage in an accident and file a claim for compensation with an insurance company, you may be surprised to receive a response back from the insurer denying your claim. When you believe you are entitled to receive compensation from an insurer, you should know what your rights are and what steps you can take after the insurance company denies your claim. 

What Happens in a Claim Denial?

An insurance company may deny your claim in one of two ways. First, the insurer may offer you less than the full amount of money you requested when you submitted your initial claim to the insurer. Second, the insurer may decide that you are not entitled to any payment under the terms of the policy and deny your claim outright.

In a claim denial, you will usually receive a letter from the insurance company that sets forth what compensation, if any, the insurer will pay, along with an explanation of how the insurance company reached their decision. Review this explanation of decision or benefits carefully, as it may highlight what steps you may be able to take to successfully challenge the denial of your claim.

Why Are Insurance Claims Denied?

Insurers deny claims in part or in full for a variety of reasons, such as:

• You have requested more compensation than the available amount of coverage under the policy. For example, if you claim $100,000 in damages from a policy that has a policy limit of only $50,000, the insurance company will only offer you up to that policy limit.
• You have claimed a loss not covered by the policy or subject to an exclusion to coverage.
• You failed to submit your claim in a timely manner under the terms of the policy.
• You failed to submit sufficient documentation or information to back up your claim of loss or the amount of damages you have incurred.
• You were at fault for the losses that you are seeking compensation for.

For most of these reasons, you may be able to collect and furnish additional information, documents, or other evidence to bolster your claim to insurance benefits or to refute the insurance company’s determination that you are ineligible for benefits under the terms of the policy.

Steps to Take If You Receive a Denial Notice

If your insurance claim is denied, you may have options for continuing to pursue compensation or benefits from the insurance company. Steps to take after receiving a denial notice include:

• Do not sign any paperwork sent by the insurance company or cash any checks. If you do, a court may later rule that you accepted the insurance company’s decision and cannot challenge it.
• Review the denial notice letter carefully to determine why the insurance company denied your claim and to identify any additional information you may be able to provide the insurer to convince them to change their decision.
• Follow the insurance company’s policies and procedures for contesting a denial. In most cases, the insurance company will allow you to file a written notice contesting the insurer’s decision within a certain timeframe, usually no more than a couple of weeks. If you wait too long to contest the decision, the insurance company may consider the matter final and close your case.
• Speak to an attorney as soon as possible to go over your rights and options and to get help from a legal expert that may be able to advocate on your behalf with the insurance company to get you additional compensation. 

Contact a Perth Amboy Personal Injury Lawyer to Discuss Your Case in New Jersey

Did you or a loved one sustain serious injuries in New Jersey? Don’t let the medical bills pile up while you wait for the negligent party or their insurance company to do the right thing. Right now, you need an aggressive personal injury attorney on your side, fighting to get you the compensation you need, want, and deserve. The skilled attorneys at CourtLaw represent clients injured in Camden, Passaic, Union City, Bayonne, and throughout New Jersey. Call (732) 442-5900 or fill out our online contact form to schedule a free consultation about your case. We have an office conveniently located at 163 Market St., Perth Amboy, NJ 08861, as well as offices in New Brunswick, Roselle, East Orange, Jersey City, Elizabeth, Linden, Newark, Paterson, South Amboy, Trenton.

The articles on this blog are for informative purposes only and are no substitute for legal advice or an attorney-client relationship. If you are seeking legal advice, please contact our law firm directly.