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How to Fight an Insurance Claim That’s Been Denied

When an insurance claim gets denied, you may feel frustrated and stressed, especially if you are still dealing with medical bills and other costs related to the accident. Fortunately, if the insurance company denies your car accident claim, you can fight back.

The first thing that you should do is review the denial letter from your insurance company. In some cases, a simple mistake may have resulted in the denial. If the rejection is based on something more serious, such as the insurance company saying that your policy does not cover your injuries, you will need to take additional steps.

You should review your insurance policy to determine your coverage. Knowing your policy limits and coverages is key to receiving the compensation you deserve.

The next step is to submit a claim appeal letter. Explain in your appeals letter the reason you believe your claim should’ve been accepted. Include any evidence you have, such as photographs, eyewitness reports, and medical records.

Appealing an insurance claim denial is complex and requires the experience and skills of an auto accident lawyer. Your attorney will need to examine your claim denial letter and policy to understand why the insurance company denied your claim. Your lawyer can then gather the evidence you need to win your appeal.

Understanding Your Claim Denial Letter

A claim denial letter is a formal notice from an insurance company informing a policyholder that their claim has been denied. This letter typically outlines the reasons for the denial and may provide information on how to appeal the decision.

Receiving a claim denial letter can be frustrating and confusing, but it is important to understand why your claim was denied and your options for appealing the decision.

If you received a claim denial letter, the first thing you should do is review the letter carefully. Many times, the reason for the denial will be stated clearly.

If you need help understanding why your claim was denied, you can call the insurance company and ask for clarification. In some cases, you may be able to appeal the decision by providing additional documentation or evidence.

If you are not satisfied with the insurance company’s decision, you can file a complaint with your state’s insurance department. Each state has different procedures for filing complaints.

It is important to remember that claim denial letters are not always final. If you have questions or believe your claim was wrongly denied, you should contact an experienced Arkansas car accident attorney who can help you navigate the appeals process.

What Do I Do If I Received a Settlement Offer Letter Instead?

A settlement offer letter proposes a resolution to a car accident dispute. The letter usually outlines the terms of the proposed settlement, including any financial compensation involved.

The settlement offer letter is typically the first step in negotiations between the parties involved. If both sides can agree on the terms of the settlement, then a formal agreement is drafted and executed. If not, the negotiation process continues until an agreement is reached or until one party decides to walk away from the negotiation.

If you receive a settlement offer letter, it means that the insurance company has decided to offer you a certain amount of money to settle your personal injury claim. While it is up to you whether or not to accept the offer, you should keep a few things in mind before making a decision.

First, you should make sure that you understand all the terms of the offer. The insurance company will often include a release of liability. This means you give up your right to sue the at-fault party if you accept the settlement. For this reason, any offer you agree to must adequately cover all of your medical expenses and any lost wages from time missed at work.

Once you have reviewed the terms of the offer, you can either accept or reject it. If you decide to accept the offer, you will need to sign and return the release of liability. Once the insurance company receives the signed release, they will send you a check for the settlement amount.

If you reject the offer, you can continue negotiating with the insurance company or file a personal injury lawsuit. An experienced Arkansas car accident attorney can help you determine whether or not filing a lawsuit is in your best interest.

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Why Did Your Car Insurance Company Deny Your Claim?

There are numerous reasons why a legitimate insurance claim gets denied. Understanding those reasons can give you insight into how to fight these denials.

Some of the top reasons why insurance companies reject most claims include the following:

Insurance Policy Has Expired

This one is simple – if the at-fault driver’s policy has expired, the insurance company will deny the claim against the at-fault driver’s insurance policy. When the at-fault driver lets their insurance policy lapse, you can make an uninsured motorist claim through your policy. This is one reason you must ensure you have purchased a “full coverage” policy.

Policy Exclusions

Policy exclusions are one of the most common reasons for a car accident claim denial. Policy exclusions are clauses in your insurance policy that specifically exclude certain types of accidents or damages from being covered.

For example, if you have a policy exclusion for “acts of God,” your insurer can deny your claim if they determine that the accident was caused by something beyond your control, like severe weather. Other standard policy exclusions include those for pre-existing damage, alcohol-related accidents, and accidents that occur outside of the country.

If your insurance company denies your claim due to a policy exclusion, you may still be able to appeal the decision.

Your Plan Doesn’t Have Full Coverage

In Arkansas, an automobile owner is allowed to reject full coverage. The law only requires drivers to carry liability. If you are at fault, your insurance will cover the other driver who wasn’t at fault, but you will have nothing to pay you for your expenses incurred and sustained losses.

For this reason, drivers should purchase a more comprehensive plan whenever possible. This comprehensive plan might include full coverage, Personal Injury Protection (PIP), or uninsured motorist coverage.

Full coverage includes liability insurance that protects the other driver when you are at fault. Personal Injury Protection provides medical payment insurance to pay your medical bills and also provides some wage-loss protection. Uninsured motorist coverage applies when the other driver is at fault but has no liability insurance.

You might have selected a liability plan because it was the most affordable, but make sure you know what is at risk when you choose the cheapest option.

Uninsured Motorist Accidents

Uninsured Motorist Protection (UM) applies when the other driver is at-fault but does not carry insurance at all. Underinsured Motorist Protection (UIM) applies when a driver carries the bare minimum insurance, and this isn’t enough to pay your damages.

If you get into an accident with an uninsured motorist, the insurance company will deny your claim if you don’t have a UM/UIM policy.

You Committed a Crime

If you were under the influence of drugs or alcohol and caused an accident, your insurance company will not cover expenses caused by your negligence. If you committed a crime at the time of the accident, the insurance company might deny your claim due to your negligence.

Your Driver’s License is Invalid

If you’re involved in a car accident and don’t have a valid driver’s license, your insurance company may deny your claim. This is because they may view you as a high-risk driver.

There are a few ways to avoid this situation. First, make sure that you always have a valid driver’s license. If your license has expired, make sure to renew it before driving. Secondly, if you’re involved in an accident, be honest with your insurance company about your status. They may be more likely to work with you if you’re upfront about the situation.

You’re an Excluded Driver on the Policy

Some insurance policies name specific drivers who are excluded from coverage. This means that the policy will not cover damages caused by those drivers. The insurance company will deny the claim if you’re an excluded driver on a policy.

You Didn’t Report the Incident on Time

Don’t wait to report an incident to your insurance company. They have the right to argue that they didn’t have enough time to research a claim if a significant amount of time has passed since the accident.

There is a Liability Dispute

An insurance adjuster could reject your claim because there’s been a dispute about who was at fault. They could also disagree with the damages you’re claiming. To avoid a dispute with your insurance company, a police report, photos of the scene, damage, and witness testimonials can help.

Bad Faith

Bad faith in the insurance industry can result in a car accident claim getting denied. This is because insurance companies must act in good faith when handling claims. If an insurance company acts in bad faith, it can face liability for damages.

There are several ways that bad faith can result in claim denial. For instance, an insurance company may deny a claim without investigating it. Or, an insurance company may refuse to pay a claim without giving a reason. Additionally, an insurance company may try to delay the payment of a claim.

If you received a claim denial after a car accident, you might have grounds for a bad faith claim against your insurance company. An experienced Arkansas personal injury attorney can help you understand your legal options.

Appeal Your Car Insurance Claim Denial

If you are appealing a car insurance claim denial, there are some specific steps you will need to take. The appeals process is often difficult and time-consuming. To avoid unnecessary delays, it is best to have this process handled by an experienced Arkansas car accident attorney.

Your attorney will go to work appealing your claim denial while you focus on your recovery and on rebuilding your life after a car accident. To do this, your attorney will:

Gather Evidence

If you’ve been denied a car insurance claim, don’t despair. You may be able to appeal the decision and have your claim paid. The first step is to gather evidence to support your appeal. This may include:

  •  Documentation of the damages incurred
  • Eyewitness statements
  • Photographs of the accident scene
  • Bill of Rights
  • Insurance policy information
  • Medical reports
  • Police reports

 

Draft an Appeal Letter

Once you have the necessary evidence and information, you’ll need to write a letter to your insurance company outlining your case and requesting a review of the decision. This is an appeal letter.

If your insurance company denies your appeal, you can file a complaint with the state insurance commissioner’s office. This office will investigate your claim and determine if the denial was justified. They may order the insurance company to pay your claim if they find it wasn’t.

OUR AUTO ACCIDENT CASE RESULTS

$1.2 MIL

HEAD INJURY | BROKEN BONE AUTO ACCIDENT

$700,000

BRAIN & BACK INJURY AUTO ACCIDENT

$4.5 MIL

WRONGFUL DEATH AUTO ACCIDENT

$350,000

HEAD & HEARING LOSS INJURY AUTO ACCIDENT

Let Our Attorneys Advocate for You

At Rainwater, Holt & Sexton, our Arkansas car accident lawyers have decades of experience representing injured accident victims after a claim denial. Our attorneys have gone toe-to-toe with large insurance companies after unfair denials and won. That’s because we believe in fighting aggressively for injured accident victims and protecting them from unscrupulous insurance adjusters who would deny their claim simply to save money.

With nine offices in Arkansas and Tennessee – Little Rock, Little Rock-Corporate Hill, Springdale, Conway, Hot Springs, Bryant, Jacksonville, Jonesboro, and Memphis– our personal injury lawyers are easily accessible when you need help.

Connect with us today for a free case evaluation.

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