What To Do If Denied Coverage For Injury Claim

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If you receive a notice saying that you have been denied coverage for your injury claim, you have learned about the judgment call taken by a single person, the adjuster. Understand that he does not have the final word. His reasoning might demonstrate a misunderstanding of all the facts. The reasoning that led him to make his decision was probably based on one of the following assumptions:

-Your insurance policy provided you with coverage up to a certain date; the date of the accident exceeded the time period during which you qualified for coverage.
-The person that caused the accident is not covered.
-The location of the accident is not covered.
-You cannot make a claim, due to the existence of your state’s no-fault insurance law.

What you should do next

Contact the adjuster and request a written explanation for his decision. Seek specifics on the policy provisions that served as a basis for the adjuster’s decision. If the adjuster does not honor your request, if he does not send you a written explanation, then write a letter to the adjuster. In your letter be certain to mention your earlier request, so that you have a written confirmation of that previous conversation. Naturally, you should make and keep a copy of that same letter.

Once your letter has been received, it should get placed in the company’s file, along with the other papers related to your case. When the insurance claims supervisor sees that letter, he will not be pleased with the adjuster’s failure to take action. He knows that in a court of law, that filed letter could be used to show lack of cooperation on the part of the insurance company.

If the denial came from the insurance of the opposing party, contact that company and ask for a copy of the insured’s policy. If you do not receive a copy, then follow the procedure used with your own insurance. Write a letter that confirms your conversation; remember to make a keep a copy for your own file, even though it will go in that company’s file.

Why you have grounds for questioning a denial

Any policy can be read in more than one way. If some ambiguity has been given as the reason for denying your claim, your Personal Injury Lawyer in Waterloo should not hesitate to take the case to court. A court should interpret that ambiguity, not the people that wrote the policy.

As you seek to learn more about the denial, you should also study further the situation at the time of the accident. Try to find evidence that someone else helped to create that particular situation. The insurance for that same person might then be asked to provide the coverage that you have, so far, been denied.

510 thoughts to “What To Do If Denied Coverage For Injury Claim”

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