How to Handle Your Personal Injury Claim Denial

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When you are injured in an accident, one of the first steps to take is to file a claim against the responsible insurance company, whether it’s against your own insurer (a first-party claim) or against the faulty party’s insurer (a third-party claim). If the insurance company denies your personal injury claim, you should investigate the justification for the denial. The denial may be valid, but there are times when claim insurers wrongfully deny claims. Let’s take a look at your options if your insurer denies your injury claim.

Examine Your Insurance Policy and Claim Denial

If your insurance company denies your personal injury claim, the first step is to review the language of your claim denial and your insurance policy. Ideally, your claim denial should clearly state why your insurer denied your claim, but this is not always the case. Carefully review your insurance policy and compare it to your insurer’s reasons for denying your claim. Perhaps your policy includes certain injury exclusions you were unaware of, and this is why they denied your claim. Whatever the reason, always make sure that your policy contains justification for your claim denial.

Contact Your Insurance Company

If you need more information about why your insurer denied your claim, if your denial contains errors or if you believe your claim was unjustly denied, contact your insurance company. Draft a letter thoroughly yet concisely detailing why the denial is erroneous. It’s a good idea to consult a personal injury lawyer to help you draft an appropriate letter, particularly if your letter is disputing the claim denial. Additionally, certain insurers require additional action such as arbitration in order to dispute a claim denial. If your insurer requires this kind of dispute-resolution service, a personal injury lawyer can greatly benefit you.

Taking Legal Action Against Your Insurer

Whether you made your claim against your own insurance company or that of a faulty party, the insurer has a duty to act in good faith and uphold the terms of their policy contract. If the insurance company fails to uphold either of these standards, you are entitled to take legal action against them.

An insurer acts in Bad Faith when it fails to treat you fairly and justly, such as by unreasonably denying your claim, not investigating your claim or failing to negotiate a settlement. In cases of Bad Faith, you are entitled to compensation for the damages from your injury claim as well as compensation for any emotional distress the insurer caused you. Compensation for your emotional distress is known as punitive damages.

If your insurer fails to uphold the terms of your policy contract, they are liable for a breach of contract. When you sign your insurance policy, you enter a contract with your insurer, and they are responsible for upholding their end of the contract. If your injuries qualify as a loss under the terms of your contract, your insurer has a duty to compensate you for your damages. If the terms of the contract and claim denial demonstrate that your insurer wrongfully denied your claim, you are entitled to appropriate compensation for your injuries as well as compensation for any damages resulting from the initial claim denial.

Contact a Personal Injury Lawyer

Peter Davis Law proudly serves the Paterson, NJ area. Contact a professional personal injury lawyer today if you need legal advice or representation.