What Happens if an Insurance Company Denies Your Injury Claim?

When an insurance company denies your injury claim, you may need help to protect what you’re owed, and it’s important to move quickly. A North Carolina personal injury lawyer can help you understand the process and protect your rights.

What Happens if an Insurance Company Denies Your Injury Claim?

Go Over the Denial Letter

Step one is to look over your denial letter with your attorney and find out exactly why the insurer turned down the claim. This could be anything from questions about who caused the accident to whether your injuries connect directly to it, and in some cases it’s primarily missing paperwork. 

Review Your Policy

The next step is to carefully review your insurance policy or the at-fault driver’s policy details and compare the denial reasons against the actual coverage language. You’ll also need to check any deadlines mentioned in the policy for appeals or further action, because if you don’t take action before that deadline, your denial can become permanent. Again, your lawyer can do this for you, and an experienced personal injury attorney will know how to read all the jargon. 

Gather and Organize Evidence

Once you know what’s wrong, you can start collecting everything that supports your appeal. This could be your medical records, police reports, witness statements, photos of an accident scene and your injuries, and repair estimates, among other things. The evidence you need will depend on precisely why your claim was denied.

Filing an Internal Appeal 

Most policies require you to send a written appeal to them, first. Your lawyer can write an appeal letter that is factual, notes all the important details, and references exactly why their denial letter is incorrect in light of what the policy says. The insurer must review your appeal and send a written response. Many claims get approved or improved at this stage, especially once they see you have a lawyer helping you.

Next Steps in North Carolina

If the internal appeal fails, you can file a complaint with the North Carolina Department of Insurance. The department cannot force payment, but once you notify them, this often prompts an insurer to reconsider. 

Considering a Lawsuit

If nothing else works, you may need to file a civil lawsuit against the at-fault party whose insurance is denying your claim. You’re not able to bring a bad-faith claim against an insurance company directly unless it’s your own insurer, so what you’re doing is pushing the at-fault party to bring a claim against their insurer for bad faith. 

Talk to a Personal Injury Lawyer

An experienced attorney knows how to review evidence, denial letters, and policies. Your lawyer can then handle all communication with the insurer, build a demand package, meet all deadlines, and deal with negotiations and a potential lawsuit. This means you avoid the guesswork and pressure of dealing with adjusters alone. 

If you have received a denial, contact David and Associates Injury Attorneys in Wilmington, Clinton, Supply, Jacksonville, Wallace, or Whiteville, NC today for a free consultation. 

Tags: denied claims, injury claims
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