Insurance is supposed to be there to protect us when things go wrong. That’s why it’s so devastating when you file an injury claim and it’s denied. Unfortunately, this happens all too often. Insurance companies have all sorts of reasons why they deny claims, but that doesn’t make it better for those who desperately need the coverage they pay for and then have it refused. You can, however, challenge an insurance denial, if you take the right steps. Learn what to do when the insurance company denies your personal injury claim, and how a personal injury attorney in Winston-Salem can help your case.
Review the Denial and Your Policy
The first step is to take a breath and get calm. Set the denial aside for a bit if you need to, then come back to it with fresh eyes and read it over very carefully. Study and take note of the exact language used, especially in the reasons for denial.
Use these reasons to search your insurance policy for exclusions. Many policies have these and they can be buried in the massive text. That’s why you want to look for similar terminology as was used in the denial letter.
It may be that there is fine print in your policy that serves as the reason your claim wasn’t awarded. It may also, however, be that there are mistaken assumptions, erroneous information or things that aren’t entirely clear.
Challenging the Refusal
Your next step, if you think your claim was denied in error, is to write a letter to the insurance company. Be clear and concise and avoid emotional language. If there’s anything that is incorrect, point it out and explain why. If there’s anything that’s not clear, ask the insurer to clarify.
At this point, they should respond with either clarification or a request for further action. Some policies require mediation or arbitration to resolve disputes, which can be a good thing as it forces them to pay special attention to your claim, and to face you as a person rather than a policy number.
Causes for Legal Action
If the insurance company acts in direct violation of your policy, doesn’t respond to your challenge, refuses to investigate the claim, or otherwise mistreats you, you may have cause to file legal action. Failing to pay a claim that your policy should expressly cover is a breach of contract between the insurance company and you. Failing to discuss the denial, failure to investigate your claim, or mistreating you in any way constitutes acting in bad faith.
Breach of contract and bad faith are both reasons you might file a lawsuit against your insurance company, and these can open you up to not only getting your original claim, but for additional damages caused by the stress of fighting the denial.
Call a Personal Injury Attorney in Winston-Salem
If you have been denied an insurance claim unfairly, seek help from an experienced personal injury attorney in Winston-Salem. The attorneys at Lewis & Keller have won over $10 million in settlements and verdicts for the people we represent, and we have the knowledge and experience to help you. Give us a call today, or fill out our free case evaluation form below, and let’s talk about your case.