When you’ve suffered a major injury, one of the first things you’ll likely do is to file a claim with your insurance company. Most people have some level of insurance, and this coverage can be the ideal solution for supporting yourself until your injuries have healed enough to allow you to return to work.
However, it is very common for insurance companies to deny your claim, which can place you in a tremendously difficult situation. Fortunately, if you have the right advice and legal representation you can fight a claim denial and get your compensation. Find out the best way to respond after your injury claim has been denied and learn when you should work with a personal injury lawyer.
Review Your Policy
Once your insurance company has sent you a denial letter, the first thing that you need to do is compare the letter against your insurance company. Few people read their policies in-depth, but this is your best resource for finding out why your claim was denied.
Somewhere inside of your insurance policy, there are likely to be exclusions, which are conditions and injuries that have been excluded from your policy. An excluded injury or ailment is one of the primary reasons for a claim denial.
In addition to examining your policy, you also need to closely read your denial level. Look for incorrect or intentionally misleading information. This will be very useful when it comes time to challenge your denial.
Send Your Own Letter
After reading your policy and your denial letter, you now must send a letter of your own to your insurance company. This is known as a dispute letter. Your dispute letter should point out the specific areas of the denial letter that you feel are either unclear, inaccurate or contain false information. Be as concise as possible when writing your dispute letter.
Once your insurer has received your dispute letter, it is common practice for them to request an arbitration hearing. Arbitration hearings often work in the favor of the insurance company, which means you should never attend one of these hearings without a personal injury lawyer on your side.
When You’ll Need File a Lawsuit
Your insurance company hopes that you will abandon your claim, which is why they will often delay responding to your dispute. If you can’t get a response to your dispute, or if the response didn’t meet your needs, you should consider filing a lawsuit with the help of your personal injury lawyer. Breach of contract and bad faith are the two reasons to file a suit against your insurer.
In a bad faith lawsuit, you and your attorney will prove that your insurance handled your case improperly, which usually includes a failure to investigate your injury. Breach of contract centers around showing that your insurer is not fulfilling the terms of your policy, such as denying a claim for an injury that is included in your coverage.
Hire a Personal Injury Lawyer
If you’re looking for help responding to an injury claim denial, you need to consult a personal injury lawyer like Robert White or Greta Braker. The legal team at Braker White is here to help with your claim and fight for your compensation.
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