If you or somebody you love has been injured in an accident, it is likely that you will need to file a claim against an insurance carrier (your own or another party’s carrier) in order to recover compensation for your losses. In most cases, personal injury claims are settled between negotiations with the insurance carrier and the injured party (or their legal team). However, there are various reasons why an insurance carrier might deny coverage of a claim.
Why would a claim be denied?
There could be a variety of reasons why an insurance claims adjuster would initially deny coverage of a claim. This could include:
- A lapsed insurance policy (failure to pay the bill)
- The nature and location of the accident not being covered under the terms of the policy
- The person who caused the accident not covered under the policy
- Disputes about how the accident happened or disputes relating to the extent of the injuries
- Not qualifying to make third-party claims based on Pennsylvania’s limited tort policies
When an insurance claims adjuster says that there will be no coverage for your accident, that does not mean that your case is over. This is often a negotiating tactic used by insurance companies in an effort to pay less in a settlement.
How to respond to an insurance claim denial
There are several steps you can take after receiving an insurance claim denial.
- Ask for a written explanation of the insurance carrier’s reasons for denying the claim. Specifically, ask them to reference parts of the policy that they are using to deny or limit coverage.
- If the insurance carrier refuses to give you a written explanation, you need to write them a letter confirming the conversation you had with the claims adjuster, the denial of coverage, and the refusal to explain the denial in writing. Sending this letter may pressure the insurance carrier into providing a settlement.
- If the insurance carrier of an at-fault party is denying coverage, ask them to provide you with a copy of the insured person’s policy so you can read it yourself. Again, if the insurance adjuster refuses to do so, write a letter to the adjuster confirming this refusal so that it becomes part of the file.
- If you and an insurance company cannot come to an agreement, and the carrier is still denying coverage that you believe you are rightfully owed, you may need to seek assistance from a skilled attorney to file a lawsuit to recover compensation.
Call a Local Attorney
If you or somebody you love has been injured in an accident and are having trouble getting coverage from an insurance carrier, seek legal assistance as soon as possible. At the Ciccarelli Law Offices, our qualified and experienced team has the resources to investigate every aspect of your claim. We will do everything we can to prove liability and refute the insurance carrier that denied your claim. Our goal is to secure full compensation for your losses. We guarantee that we will not be intimidated by aggressive insurance carriers, and we are not afraid to take a case to trial if we have to. When you need a Philadelphia personal injury lawyer, you can contact us for a free consultation of your case by clicking here or calling (215) 228-0100.