Bronx Insurance Claims Denial

If you have been in an accident, filed an insurance claim, and it was denied, that does not necessarily mean that it is the final word. It doesn’t mean that you have to  accept the denial or low ball offer and move on – in fact, you shouldn’t. This is not the time to end your negotiations with the insurance company or walk away from your claim. There are still steps you can take to get compensation for your injuries and damages.

Read Your Claim Denial Letter

It is important to carefully read your claim denial letter. It will tell you why your claim was denied and give you vital information for moving forward and appealing the decision. Don’t skim the letter or just read the part that says you were denied – read it all. Also, don’t throw it away. Put it somewhere safe and keep it for reference, especially during your appeal.

Reasons a Claim is Denied

There are many reasons why a claim may be denied. The claim’s adjuster for the insurance may believe there is no merit to the claim or the adjuster may hope that you will just go away and not pursue appealing the claim. Some of the more common reasons for claim denial include:

  • The adjuster is opting to believe a different account, such as their client or an eyewitness (if there is not a police report).
  • The insurance policy has lapsed.
  • The cost of the damages exceeds the limits of the policy.
  • Certain exclusions that are in the policy may not cover certain aspects of the accidents.
  • The accident was reported past the time the policy requires.

See if there is a Process for Formal Appeals

Some insurance companies have a formal process that a person must follow when appealing a claim denial or low offer. It can usually be found in the denial letter, which is another good reason to read it through. If you filed the claim with your own insurance company, check your policy to see if it is included there. You can also call the insurance company or visit their website to see if it is listed there. If there is a formal process, make sure that you follow it to the letter.

Determine if Filing an Appeal is Reasonable

Filing an appeal may involve getting an attorney. Most experts recommend getting an attorney for an appeal if you don’t have one already. This will incur additional costs. This means that you probably don’t want to pursue the appeal if it won’t be cost effective. Your attorney can tell you if the claim has any chance of succeeding or if it is even worth doing. If the amount you get is so minimal that it will be consumed by the additional fees, there really isn’t any sense to doing it. Carefully consider whether the costs that will be incurred by a lawsuit will outweigh any compensation you get, thus negating the benefits.

Review the Evidence You Originally Submitted

Go back over the evidence that you submitted to the insurance company when you first filed the claim. See how it lines up with the reason you were given for the denial. If it is a low offer, look with a critical eye to see if you can make the evidence any stronger or support your claim better. Have you found other information that would be helpful? Begin assembling the evidence for your appeal.

Contest the Denial

Write a letter that clearly explains why your evidence refutes the decision of the insurance company. Include copied of any of the evidence – even if you included it in the original claim – along with a detailed report that shows a direct link between each piece of your evidence and the claim.

Hire an Attorney

Auto accidents claims can be difficult to manage and appeals even more so. A good attorney will keep your best interest in mind and make the process easier for you by taking over the filing, negotiation, and communication. They handle the any appeals and related issues while you focus on recovering and getting back to your normal life.

If your insurance claim was denied or the amount isn’t enough to cover your expenses, don’t try to go it alone. You have enough to worry about; let the attorneys at The Law Offices of Ivan M. Diamond take over your case and get the compensation you deserve. Call us today at 877-960-1702 for a free consultation and let us help you. Don’t wait another day, call now.