Whenever there is a report of an accident, whether caused on an icy sidewalk or simply a collision on a bumpy road, the consequences can be really bad. It can make you go through the most tiring process that you can imagine and the emotional turmoil that comes with it adds to the cherry on top.
But in all of the fuss, there is always a hidden hope that insurance will come and save you from all the emotional distress.
To get all the compensation from the pain and to get financial relief using insurance and personal injury claims, hiring a personal injury attorney in Arlington can help a lot. However, it is not fun and games all the time, this journey can come with insurance denials and can bring unexpected hindrances.
Understanding Insurance Denials
A lot of times, when there is an insurance denial, people tend to think that the insurance company is getting on their nerves for no reason at all. However, this is not the case. The insurance companies have some set policies and guidelines that need to be followed. So, it is better to understand the causes and the major reasons behind these denials. Let’s have a look at all the reasons that end up causing denials.
Policy Exclusion
Now, that we all know that an insurance company comes with a few policies, here are a number of exclusions that you need to deal with too. It means that there are certain conditions and scenarios in which the insurer won’t cover the claim.
It is best to familiarize yourself with all the exclusions before filing. For example, if you do not own the first-party car insurance coverage, then your own company might deny the claim that you are making.
There are some other limitations as well like the events they cover. Also, it is very important to keep a look at the expiration of the insurance that can be due to nonpayment.
Not Sufficient Documentation
Now, insurance claims need and require solid evidence that includes medical records, the incident’s photos and videos or the statements given by the witnesses. When there is a lack of this documentation, the chances of the denial do increase.
This is majorly because of the claim losing its credibility due to the presence of adequate documentation making shaky grounds for the denial.
Disputed Liability
One of the most disliked reasons for an insurance denial can be the liability dispute. What is it, you may ask?
Well, it is the insurance company trying to blame you for the accident that occurred or place liability on the third party. The policyholder usually thinks that you have a bigger role in the incident that leads to the payout or denial.
Failure in Seeking Medical Care
There are a lot of insurance companies that think that claimants should be getting medical attention for injuries right away after an incident occurs.
If there is a delay in seeking medical attention or care, this can be used as a bigger reason by the insurance company to deny your claims. There is a high chance that the company thinks that your injuries were not even close to bad, enough for you to visit a hospital.
Pre-Existing Injury
In case of the access given, the insurance company can easily look into your medical history and dive in to find reasons to deny your claim.
To stay away from that, the best way is to not sign the Medical Authorization Release Form that is sent by the insurer unless it is reviewed by a brain injury lawyer.
In case your injury is exacerbated due to the recent one, you can still qualify for benefits for your health in recent times, compared to how it was before the accident.
Important Steps to Take After a Denial
It is best not to lose hope when it comes to your insurance getting denied. Here are some of the steps that can help you.
Seek Legal Help
If by any chance, you think that your denial is unjust and is not right, it is best to seek legal advice. This can be done by consulting a personal injury lawyers.
File an Appeal
If you think that the denial wasn’t needed and has an error, it is best to back up the claim with the needed documentation. Just try and remember to do it within the timeframe that is provided to you in accordance with the insurance policy.
Make Contact with the Agent
Make sure that you discuss the denial details with your insurance agent. They can help you a lot by providing insights regarding the denial and can help with useful advice regarding the appeal process.
Review the Denial Letter
Well, one of the most important things to take into consideration here is that you should go through the denial letter in detail and try to better understand the reason behind the denial. It does help a lot with finding the right direction for the next steps to be taken.
Insurance denials can be really challenging but better understanding the reasons behind them is the key to go. Taking protective measures can help immensely to increase your chances of a successful appeal.