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What to Do If Your Insurance Claim Is Denied

Image by Republica from Pixabay 

If you have been injured in a car accident, or your vehicle has been damaged, you want to be able to make an insurance claim to cover associated costs. Additionally, if one of your employees happens to be injured while driving a company car, you will want to file an insurance claim.

This claim may be against your own insurance or the insurance of another driver, depending on the circumstances.

When you make your insurance claim, the last thing you need is for it to be rejected. However, such a rejection can happen. It’s important to understand why this is the case and what you can do if you have issues with any refusal you receive.


Why Might an Insurance Claim Be Rejected?

There are several reasons why an insurer might decide to reject your car insurance claim.

You Could Have Avoided the Accident

If the insurer believes you reasonably could have avoided the accident, or that you contributed to it, they may refuse your insurance claim. This is especially likely in circumstances such as driving drunk or without a license.

There Was No Indication of Injury or Treatment at the Time of the Accident

This is one reason why it’s so important to seek medical attention as soon as an accident occurs. If you fail to do so, you may have problems convincing the insurer that the injuries you are claiming for are a direct result of the accident.

There Are No Medical Records to Support Your Insurance Claim

If your claim is due to injury then it may be refused if there are no medical records to substantiate it.

There Was a Pre-Existing Condition

Insurers may argue that pain and suffering is the result of the condition and not the accident.

There Are Exclusions in the Policy

Many insurance policies contain a number of exclusions. This is why it’s important to be very careful when choosing a policy.

You Have Not Paid Your Premiums up to Date

If you haven’t paid your premiums faithfully, your policy might have lapsed.

If none of these situations apply, or you do not agree with the insurer’s decision, you need to take action.

What to Do When Your Insurance Claim Is Rejected

There may be times when a car insurance provider acts in “bad faith.” This means it fails to provide you with the agreed provision as detailed in your insurance policy.

When this happens, you need to take action to try and get the decision overturned. For this reason, it’s a good idea to take another look at your vehicle insurance policy. You should check that you are fully covered and that there are no exclusions which apply.

If you still believe that your insurance company has incorrectly rejected your insurance claim, you can send a letter of complaint to the insurer. Additionally, you have the option of contacting the state insurance commissioners. They can provide you with advice and help you with your case. However, if the case is complicated, or you are having problems resolving it, it’s often a good idea to speak with an experienced lawyer.


Taking one or all of these actions should help you to resolve any issues you have following the refusal of a car insurance claim.