One of the most frustrating things that can happen to an accident victim is to have their insurance claim denied. They have already been through enough dealing with property damage claims and recovering from injuries. The accident turned their life upside down, and now they want to receive the money they deserve and get back to their everyday life.

Unfortunately, insurance companies are known for intentionally undervaluing and denying valid personal injury claims. Insurance companies are for-profit businesses. Paying insurance claims decreases their profits.

Therefore, the insurance company might use any excuse it can find to deny your claim, including engaging in bad faith insurance practices. It might try to cheat you out of the compensation you deserve for your injuries, lost wages, pain & suffering, medical bills, and other damages.

Reasons Why Your Insurance Claim Was Denied

There are numerous reasons why the insurance provider for the other party could deny your insurance claim. Some of the common reasons that an insurance company might give for denying a personal injury claim include:

  • Its insured was not responsible for the accident or your injury
  • You contributed to the cause of the accident or your injury
  • The policy did not cover the accident or situation that caused your injury
  • The accident was not the cause of your injury
  • You did not file a timely claim
  • The insurance policy lapsed
  • You failed to provide adequate documentation of injuries and financial losses
  • The medical documentation does not substantiate your claim for damages

When you receive the denial letter from the insurance company, read the letter carefully. Make sure that you understand the reason why the insurance company is denying your claim. Also, make sure that you understand the deadline for filing an appeal or request for review.

Filing an Appeal of a Denial of an Insurance Claim

The denial letter should provide instructions for filing an appeal or requesting an internal review. Note the deadline for filing the appeal because you do not want to miss that deadline. If you have questions about filing an appeal, you might want to contact a personal injury attorney for assistance. 

A lawyer can help you gather additional evidence and documentation that might result in the approval of your claim. A lawyer can also spot when an insurance company is engaging in bad faith insurance practices by wrongfully denying a valid injury claim.

The appeals process can be aggravating and long. The insurance company may drag out the process hoping that you will give up or accept a low settlement offer. Some companies send numerous requests for additional information and deny the appeal if you fail to respond quickly or make a simple error during the process.

What Can I Do If the Insurance Company Denies My Appeal?

If the insurance company denies your appeal, you might need to file a personal injury lawsuit. Oklahoma is an at-fault state for car accidents, slip and fall accidents, and most other personal injury claims. You must prove that the other party caused your injury through negligence or wrongdoing to recover compensation for damages.

When you file a personal injury lawsuit, you do not name the insurance company as a defendant. The defendant is the person or party who caused your injury. For example, if another driver caused your motorcycle accident, you would file a lawsuit against the driver instead of the driver’s liability insurance company. 

Most liability insurance providers hire an attorney to represent their insured in the lawsuit. The insured can hire an independent attorney to represent them as well. 

Some lawsuits might settle before the trial begins. A personal injury lawyer continues to negotiate with the insurance provider to settle the case. After reviewing your evidence, the insurance company may realize that you are likely to win at trial and decide to settle the case.

If the insurance company refuses to settle your claim, the case goes to trial. A jury decides who is at fault and how much compensation the other party should receive for damages.

Under Oklahoma Statutes §12-95, most personal injury lawsuits must be filed within two years of the injury or accident date. There are very few exceptions to this rule. Failing to file a lawsuit before the deadline means that you lose your right to pursue the claim through the court. 

If an insurance company denies your claim, do not accept the denial. Take steps to appeal the denial. A personal injury attorney can review the denial letter and explain your legal rights if you are unsure of what to do.