What If the Insurance Company Denies My Injury Claim?

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As an insured, you have been paying your premiums for a period of time leading up to your accident. Now that you’re injured, the insurance company will do its part by paying to make you whole, right? Unfortunately, some insurance companies operate in the fine print, which can limit your understanding of the terms and conditions of your coverage and result in denials of injury claims.

If you have been injured in an accident but are getting nowhere with the insurance company, call Zinda Law Group at (800) 863-5312 for a free consultation with one of our Austin personal injury attorneys.

Why Was My Claim Denied?

In order to decide what to do next, you first need to understand why the insurance company denied your claim. Injury claims are generally denied for one of three main reasons: claim problems, policy problems, and fact problems.

Claim problems consist of technical errors in the claim application, such as submitting the claim improperly or forgetting to attach certain required documentation. If your claim has been denied due to a claim problem, you should contact your insurance company to resolve the issue. Often, you can correct the error and resubmit the claim, satisfying the insurance company’s requirements and getting the coverage you’ve been paying for.

Policy problems are a bit more complicated. They arise when there is a deficiency with the policy itself. For instance, if you have inadvertently forgotten to extend or renew certain parts of your insurance policy, there may be a lapse in coverage. Most likely, the company will not cover claims from incidents that occurred during a lapse or after an expiration. Policies can also be vague or ambiguous in their terms, leading you to believe you have different coverage than what is actually in place. For most people, policy problems are difficult to challenge without the help of an attorney or other professional.

Finally, fact problems often relate to the specific details and circumstances of your injury. The insurance company may, for instance, argue that you are not as hurt as you claim because you have not provided sufficient medical records. Or they may insist that some preexisting condition lies at the root of your symptoms—meaning that the accident you suffered is not responsible for your injury. There are countless alleged fact problems the insurance company may assert to justify its decision to deny your claim.

If your claim was denied for a claim problem, you can mostly likely resolve the issue by contacting your insurance company to discuss the issue. However, if the denial is based on a policy or fact problem, you will likely not get far by contacting the insurance company. Under such circumstances, you should speak to a personal injury lawyer to understand your options.

Do I Need a Lawyer?

A personal injury attorney may recommend filing suit against the insurance company. When you sue your insurance company to get the benefit of your own policy, you assert a first-party claim. An attorney can also advise you as to third-party claims, which are those brought against the insurance company of the person who caused your injury.

The law protects people from unscrupulous insurance practices. If the insurance company fails to properly investigate your claim, lies to you about your policy, or breaches its contract with you to provide coverage in exchange for payment of premiums, you may be entitled to assert bad faith claims against the insurance company. Such claims often entail punitive damages, sanctions, and attorney’s fees.

Get Help from Experienced Austin Injury Lawyers

If you or a loved one has been hurt and need help dealing with an insurance company, the Austin injury attorneys of Zinda Law Group can assist you. Our lawyers have a wealth of experience in dealing with all types of insurance companies, and we can help you seek compensation for medical bills, property damage, lost wages, and more.

Call us today at (800) 863-5312 for a free consultation with one of our  Austin personal injury lawyers. Meetings with attorneys by appointment only.