Featured News 2018 4 Reasons Injury Claims Are Denied by Insurers

4 Reasons Injury Claims Are Denied by Insurers

If you need to file a claim with an auto insurance company, whether it is with your own insurer or that of another driver, you need to be aware of the pitfalls you're facing. Otherwise, you could find yourself with a denied claim, going without the compensation that you need for medical bills, lost income, and more.

Keep reading to find out some of the reasons your claim could be denied by an insurer, and what you can do about it.

1) According to Insurance, You Could Have Avoided the Accident

If an insurer thinks that you contributed significantly to the crash, or that you could have avoided it, then an insurer could deny your claim. For example, the adjuster could reject your claim if they think that you were driving under the influence or that you allowed someone to get behind the wheel without a license. If you are being told something along these lines, then you should consult with an attorney to get the legal counsel and backing you need to counter the claim denial.

2) You Didn't See a Doctor Right After the Crash

If you delay treatment after an accident, an insurer may be skeptical of your injury claim. And even if you were to show an injury to an insurer, but you did not go to the hospital right away, then the insurer will claim that the injury is from another incident or that it is not actually a serious injury. This reason for denial is easily prevented: go to the hospital, or at least a doctor, right away. Doing so can help you on your way to financial and physical recovery. It also establishes an official record of your medical damages—an important legal shield if you pursue a case, as you'll see below.

3) You Lack Medical Records to Prove Your Claim

If you failed to see a doctor or your records don't perfectly align to your injury claim, this one will appear pretty clear cut to an insurance adjuster. If you do not have medical records that confirm your injuries, then an insurance company has no reason to believe you. The importance of medical records to your case cannot be overstated.

4) The Injuries Appear to Come from a Pre-Existing Condition

Finally, an insurance company might discount your injuries as simply the result of a condition you already had, not the result of a devastating car wreck. Even if you do have a pre-existing condition, that doesn't disqualify you from getting reimbursed for your medical costs as a result of the crash. This will be tricky, however, as you would have to distinguish pre-existing injuries from ones caused by the crash. Doing so would require hiring a medical expert who understands your condition and the conditions created by the accident.

That is, thankfully, exactly what a lawyer does on behalf of clients—calling experts, arranging testimony, and building a case from every angle.

Has Your Insurance Claim Been Denied?

There are, of course, other common reasons that insurance adjusters choose to deny injury claims—sometimes less-than-lawfully. At other times, a denial indicates that an insurance company is acting in bad faith. Speak to an insurance adjuster to see if you can learn why your claim was denied, and how you can successfully modify the claim.

Your next step is to work with a car accident lawyer, or at least get a consultation with one. A legal professional will have the experience and technical know-how to deal with insurance and create an airtight case on your behalf. Find the car accident attorney you need on our directory today!

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