Have you had an insurance claim denied? Here’s some advice from an injury claim lawyer on the steps you can take.
Figure Out the Exact Reason for the Denial
Look over the denial letter carefully. Insurance companies are required to give a reason for the denial. Common reasons could include be incomplete documentation, disagreement about how severe the injury actually is, or a claim that the injury is not covered by your policy. It could be that you missed a deadline or weren’t following the terms of the policy.
Make sure that you understand exactly what they are saying. Once you understand why your claim has been denied, then you can decide if the denial is valid or if you should try to appeal.
Review Your Insurance Policy
Claims are sometimes denied based on specific policy details. Before you challenge the denial of your claim, review your insurance policy thoroughly. Check the exclusions, limitations, and any specific terms in your policy that could affect your claim. If the legal or technical language in the policy is confusing, consult with a lawyer to help you understand what it’s saying.
Gather Additional Evidence
If you decide to pursue an appeal after you are clear on the reason for the denial and have reread your insurance policy, look for additional evidence to support your claim. This could be additional medical records, accident reports, visual evidence such as photographs or videos, or witness statements. You might also consider getting additional medical opinions or testimony from an expert in a field connected to your injury.
Think of anything that will help to verify that your injury is indeed legitimate and should be covered by your policy. The more evidence you have, the stronger your appeal will be.
Appeal the Denial
Typically, each insurance company has its own appeals procedure for policyholders to challenge a denial of a claim. You will most likely be required to submit your formal appeal and any additional documentation to support your claim. You may need to attend a hearing if that is part of your insurance company’s appeals process. Keep records of all communication with the insurance company during the appeals process: emails, letters, recordings, or transcriptions of phone calls, and documentation of any other form of communication.
Consult with a Lawyer
An experienced personal injury attorney can assist you in understanding your case and the reasons behind the denial and help you decide on your next steps. Most importantly, a lawyer can deal with the insurance company on your behalf; insurance company representatives are skilled at listening for (and encouraging) admissions of fault, and are generally encouraged to get policyholders to settle as quickly as possible. An experienced lawyer will be familiar with these tactics, and can negotiate on your behalf to get you a fair settlement.
If you’re dealing with a denial of your insurance claim, stay persistent! Get in touch with Goldberg Injury Law in Las Vegas, NV. We can advise you as to your best course of action.
Reviewed by Katie Goldberg, founding attorney at Goldberg Injury Law.
Goldberg Injury Law
Downtown Address:
6010 S Rainbow Blvd Suite A1,
Las Vegas, NV 89118
Phone: 702-382-9797
Fax: 702-920-8670
