What to Do If the Insurance Company Denies Your Car Accident Claim
You’ve done everything right—filed a claim after your car accident, provided documentation, and waited patiently. Then comes the shock: the insurance company denies your claim. It’s frustrating, confusing, and potentially devastating—especially if you’re counting on that money to cover medical bills, lost wages, and car repairs.
Why Insurance Claims Get Denied
Understanding why your claim was denied is the first step to fighting back. Some common reasons include:
1. Disputed Liability
The insurer might believe you were fully or partially at fault and therefore not entitled to compensation under their policy rules—or they may dispute whether their insured was at fault at all.
2. Policy Exclusions
Your damages might fall outside of what the insurance policy covers. For instance, if the other driver had lapsed coverage or the accident occurred under excluded circumstances (e.g., using a personal vehicle for commercial purposes), the insurer may deny the claim.
3. Missed Deadlines
Most policies require you to report an accident within a certain time frame. Delays in filing can lead to automatic denial.
4. Lack of Evidence
If you didn’t provide enough documentation—such as medical records, police reports, or repair estimates—the insurer may claim there’s insufficient proof of injury or damage.
5. Pre-Existing Conditions
Some insurers try to argue that your injuries weren’t caused by the accident but stem from a prior condition or earlier incident.
6. Failure to Seek Prompt Medical Attention
Delaying medical treatment can lead insurers to argue that your injuries weren’t serious or were unrelated to the accident.
What You Should Do Next
A claim denial isn’t the end of the road. Here are the steps you should take immediately:
1. Review the Denial Letter Carefully
Insurance companies are required to explain the reason for a claim denial. Read the letter closely. Look for:
- The reason given for denial
- References to policy language
- Any deadlines for appeal or further documentation
Understanding their argument will help you plan an effective response.
2. Request a Copy of the Insurance Policy
If you don’t already have it, request the full policy. You have a right to see the terms and exclusions the insurer is relying on. Your attorney can review the policy and assess whether the denial was legally valid.
3. Gather More Evidence
If the denial was due to insufficient documentation, now is the time to strengthen your case. This may include:
- Additional medical records
- A letter from your doctor connecting your injuries to the accident
- Witness statements
- Accident reconstruction reports
- A second opinion on vehicle damage or repairs
Detailed, credible evidence can sometimes persuade the insurer to reconsider.
4. File an Appeal
Most insurance companies offer a formal appeals process. This typically involves submitting a written request for reconsideration along with any new evidence you’ve gathered.
Keep in mind: you usually have a limited time window to file an appeal. Don’t delay.
When to Involve an Attorney
If your appeal is denied—or if the denial seems especially unreasonable—contact a car accident attorney immediately. Legal counsel can:
- Analyze your policy and the insurer’s obligations
- Identify whether the denial was made in bad faith
- Handle all communication with the insurance company
- File a lawsuit if necessary
In some cases, a denial can open the door to additional damages if the insurer acted in bad faith—which means they unreasonably refused to honor a valid claim.
What Is Insurance Bad Faith?
When an insurance company fails to fulfill its duty to act honestly and fairly with its policyholders, it may be guilty of bad faith. This could include:
- Denying a valid claim without proper investigation
- Unreasonably delaying payment
- Misrepresenting policy terms
- Refusing to explain the denial in writing
Victims of bad faith may be entitled not only to the value of their original claim but also to additional damages for emotional distress or financial hardship.
Final Thoughts
A denied insurance claim can feel like a second accident—this time, financial. But don’t lose hope. Insurers count on people walking away without a fight, but you have options. We recommend boise car accident lawyer.
