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Practical Guide to Denied Insurance Claims and Appeals

Practical Guide to Denied Insurance Claims and Appeals

We’re all required to have auto insurance, mostly because we never know when we might get into a car accident, but as all automobile-owners know, insurance isn’t cheap. The cost of insurance has increased steadily over the last decade, and New Jersey is the sixth most expensive state for car insurance, with average expenditures totaling $1,385.61 annually in 2018, according to the National Association of Insurance Commissioners.

When you’re paying such high rates to be insured, when it comes time to file a claim, you want to know that your insurance company has your back. But the unfortunate reality is insurance companies will look for any excuse to deny your claim, so having strategies to challenge the denial is crucial. With the help of a Northern New Jersey car accident lawyer from Buttafuoco & Associates, you may be able to get the insurance compensation you need for auto repairs, medical bills, or other expenses covered by your insurance plan. In this article, I’ll describe why your insurance claim might be denied, and what you can do to challenge it.

Why Was My Claim Denied?

An insurance claim can be denied for any number of reasons, and it’s in the insurance company’s financial interest to do so. Some of these reasons are reasonable and clear-cut, such as whether you were driving while impaired by drugs or alcohol or if you were driving with an expired license. Many reasons, however, are clerical, such as making a payment late. Here are four of the most common reasons we see for claim denial:

  1. Delayed Reporting: Insurers often require prompt reporting of automobile accidents to begin the claims process, and any significant delays may raise suspicion and lead to a denial. This is why Northern New Jersey lawyers tend to recommend filling claims as soon as possible.
  2. Lack of Sufficient Evidence: Insurance companies need concrete proof of the accident’s cause, as well as the extent of injuries and damages, in order to evaluate the claim. A lack of photographs, witness statements, the police accident report, or medical bills can weaken your case. Make sure you take pictures of the accident site and save any documentation, especially medical documentation. A qualified auto accident lawyer serving Northern New Jersey can help you gather evidence relevant to your case.
  3. Policy Exclusions: A car insurance policy often has specific exclusions for certain scenarios or types of accidents. If the accident falls within these exclusions, the claim may be denied due to lack of insurance coverage. However, often these exclusions are not as cut-and-dried as the insurance company will try to make them look. Working with an attorney in Northern New Jersey may be in your best interests, even if an insurance company initially claims your injuries fall outside the scope of your auto insurance policy.
  4. Pre-existing Injuries: Insurance companies may argue that the accident only aggravated existing conditions rather than causing new injuries. This is one reason why seeking prompt medical attention after an accident and retaining all medical records are key to successful personal injury cases.

What To Do If Your Claim Is Denied

Having your car insurance claim denied can be disheartening, but it’s crucial not to give up. Before you connect with an accident attorney to discuss your options, there are several steps you can take to challenge an insurance company’s denial. Even if you receive compensation, if it’s less than you filed for, you can challenge the company’s decision.

  1. Review the reason: In the claim denial letter, they should provide an explanation for the denial. If the reason is unclear, get in contact with your insurance provider for a more detailed explanation.
  2. Review the policy: Review your insurance policy to see if the claim is covered. Don’t just take your insurance company’s word for what is and isn’t included; look at the supporting documents! This also includes learning the procedures and rules for making an appeal to challenge a denied claim. Take note of any deadlines.
  3. Gather evidence: This could include police reports, medical documents, or pictures of the damage. Each situation will be different, depending on the accident and the reason your claim was denied, so a Northern New Jersey car accident attorney can provide guidance for your particular appeal.
  4. Write an appeal letter: This is where you state your case. It may be tempting to get emotional, but insurance adjusters can only be convinced by the facts; be brief, stick to the facts, and make sure your case directly responds to the reason you were denied.

Need Legal Assistance?

If you have been denied by your insurer, working with an experienced Northern New Jersey car accident attorney from Buttafuoco & Associates can make a huge difference to your case. Our dedicated legal team will review the details of your case, gather supporting evidence, and negotiate with your insurance company to ensure you receive the compensation you deserve.

Even if your insurance company denies your appeal, the fight isn’t over. You can try again. If you’ve made an appeal and have already been denied, don’t quit! With guidance from a Northern New Jersey car accident attorney, you can continue the appeals process. Insurance companies are out for profit, but Buttafuoco & Associates will always look out for your best interests.

Call us today at 1-800-NOW-HURT.


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