Fighting or appealing a negative decision about coverage can leave you reeling. However, contacting your lawyer often gets this kind of decision overturned. On the other hand, according to insurance experts, a strongly worded letter and a well-motivated paper often get results.
To appeal a denial of a claim, you need the help of an attorney. The Hammack Law Firm can help you get coverage in many cases and stand their ground when facing insurance companies. There are also possibilities of applying for other types of coverage, including uninsured motorist claims.
But if all claimants get the best legal representation in town, how do insurance adjusters still decide to deny coverage? Let’s find out!
Reasons Why Your Insurance Company Might Deny Coverage
Insurance companies can and do deny coverage for a variety of reasons. According to insurance experts, these reasons include non-payment of insurance premiums and other issues. For example, coverage might be denied because of an accident, because you were driving illegally or because you were driving while engaged in illegal activity.
However, don’t immediately panic. Insurance companies make mistakes, and they tend to err on the side of denying coverage. Adjusters look for reasons to deny coverage of every claim. You can be denied coverage for drunk driving, driving without a valid license, and other issues like failing to avoid accidents. However, you can certainly appeal the decision, and your attorney can help you prepare the appeal.
Causes for Coverage Denial
Remember that insurance examiners study each claim before deciding whether to cover it. Adjusters are humans who make mistakes. They’re basically charged with saving the company money, and some adjusters might go overboard. The most common reasons for denial of claim coverage include the following situations:
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Excessive Claims
Claims that exceed coverage limits are usually denied, but only for the amount that exceeds the coverage.
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Discrepancies in Your File
If discrepancies appear in your records, insurance companies must investigate. These kinds of discrepancies might include incorrect personal information, inaccurate information, or missing information.
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Breaking the Law During the Time of the Accident
Insurance companies could deny coverage if you were breaking the law during the accident.
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Failure to Claim Compensation in a Timely Way
Coverage can be denied if you don’t report the accident on time or you fail to seek medical help for an injury. On the other hand, suddenly claiming whiplash a month after an accident raises suspicions of fraud.
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You’re an Excluded Driver
A policyholder can request that a covered driver be removed from coverage. A wayward child is often removed from a parent’s insurance, and this results in denied coverage.
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You’re Not Named as an Authorized Driver
Not appearing as an authorized driver might not matter in extraordinary circumstances. Sometimes, drivers need to move a vehicle in an emergency.
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Key Policy Exclusions
It’s always important to read the fine print of your insurance policy. There might be exclusions listed right on the policy. These result in certain claims being denied because the situations were never included in the insurance package. For example, common exclusions include coverage for bodily injury when providing commercial services and denial of damages caused by acts of nature like hailstorms.
Understanding Your Denial Letter
It’s critical to read your denial letter carefully. You need to understand exactly why your claim is being denied. Third-party claims are denied more frequently than first-party claims. You might try to file with your own insurance company after being denied coverage from a third-party insurer.
Try to develop a friendly, professional atmosphere when discussing the issue with a claims adjuster. Adjusters handle anywhere from 200-400 claims each month. These are probably more than they can comfortably handle, so they appreciate talking civilly with someone.
Steps to Fight an Insurance Company Denial of Coverage
There is a method for fighting against denied insurance claims. However, you must understand why the claim was denied to appeal the decision. For example, you might find that there was a mistake made in the report of the accident. Maybe dates were entered inaccurately. When reviewing your denial of coverage or settlement offer letter, the company’s decision is always based on certain facts. However, you might feel that the settlement offer is way too low or the company has inaccurate information. Both of these would be grounds for appeal.
Additionally, most states have passed an auto insurance bill of rights. You can find a copy on your state’s division of motor vehicles website. You may be protected from certain types of denials of coverage. Read this information carefully to understand your rights. You have options and rights, and your attorney can help you in your fight for coverage.
