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Personal Injury Claim Was Denied: Now What?

If you have recently been injured in an accident that was caused by another person, then you may be eligible to receive compensation for those injuries as well as other losses and damages that were incurred as a result.

Some injuries that may fall under this category may occur during a motor vehicle collision, a premises liability case, bike crash, pedestrian accident, or even defective products.

To recover compensation, the first thing that needs to be done is the filing of an injury claim with the other party’s insurance company. The insurance company will then assign the case to a claims adjuster and this is who decides if the claim will be approved or denied.

Why a Claim May Be Denied

The claims adjuster works for the insurance company, so they will be carefully reviewing each claim to determine if it is valid and legitimate before any compensation is rewarded. They have only the best interests of the insurance company in mind during this process.

A claim may be denied by the adjuster for several reasons including if the policy doesn’t cover the nature of the accident, the policy has lapsed, you failed to prove fault and negligence, the accident didn’t actually cause you any injury, or the person who caused the accident is not covered by the insurance policy.

Even if your claim is denied, you have the right to continue to pursue a claim. When this happens, you want a personal injury attorney to review the policy and the rest of the case to determine if the initial denial was made for a valid reason. Sometimes the insurance adjuster is just trying to get you to drop the claim.

Claim Denial Explanation

If the claim was denied, demand an explanation explaining their reasoning. Request a written explanation for the denial including a copy of the insurance policy that is relevant to the denial. If they fail to do this or refuse, then contact your personal injury attorney right away.

Dispute the Decision

Once you have reviewed all of the information pertaining to the denial of your claim, you can then dispute the denial or request more information. When you ask questions, make sure to get everything in writing so that all communication is properly articulated and recorded.

Again, if the insurance company continues to deny your requests or fails to provide you with the information, a personal injury attorney will prove to be helpful during this process. The attorney can explain the process to you, translate what the insurance company may be telling you, and can also explain any other claims including breach of contract and bad faith. They will be able to also pinpoint other avenues for you to explore in the event of a personal injury claim denial.

If you are unsure about the process after your claim is denied or you aren’t fully aware of all your rights, a personal injury attorney is definitely someone you want to have on your side. If not, you may find that you have accidentally waived some of your legal rights simply because you did not fully understand what the insurance company and the other lawyers were saying.

Don’t let the insurance company and adjuster bully you into dropping your claim. Contact an attorney today for legal representation and to receive the compensation you rightfully deserve.

Michael J. Babboni's wide-ranging legal career is based on the strong belief that everyone should be treated fairly and have access to effective legal help. Michael began putting his beliefs in action by helping the people of St. Petersburg Florida get what they are owed in civil trials fighting to protect families by making corporations pay, and honor their obligations.

Personal Injury Claim Was Denied: Now What?

Goldman Babboni Fernandez
Murphy & Walsh

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