If you are wondering why your insurance claim got declined, here are some relevant explanations and the legal options open to you. 

When you file a claim with your insurance company after an automobile crash, you might be banking on the funds from the payout to settle your hospital fees and other expenses.

However, events may not always go as planned, and the company may decline your insurance payout. When this happens, it’s critical to figure out why the insurer turned down the request. Of course, each scenario is unique, but insurers provide some frequent justifications for refusing claims.

Justifications for Payout Denials

The following are some typical grounds for insurance payout denials:

The Mishap May Have Been Avoided

If the crash could have been avoided, or you did anything that contributed to or prompted it, the agent may deny your insurance payout. This scenario is particularly true when the company believes you conducted an action that rendered your policy coverage ineffectual, such as driving while intoxicated at the crash or allowing an incompetent driver to use your vehicle.

If the insurer says you might have prevented the vehicle collision, you should see a lawyer immediately because the company’s attorneys may have motives that are different from yours.

You Didn’t Seek Medical Care When the Accident Happened

If you intend to assert that the car crash got you injured, you need to seek treatment at a hospital immediately after the incident happens. If you don’t, the insurance broker may allege that the crash did not genuinely cause your wounds or that they are unrelated or unconnected to the incident. 

Your case will be stronger if you can prove that you sought medical attention after the mishap and that a medical practitioner diagnosed your wounds there. Moreso, if you waste time in filing a report, the insurer may think that your injuries are fake or overstated to gain a claim because many individuals who are genuinely harmed usually seek medical attention right away.

Regrettably, some individuals who can’t afford medical treatment are labeled “fakers” due to their failure to undergo treatment when they required it. The insurance agent and the injured person frequently disagree on personal injury claims.

There Is No Indication of an Injury or Suffering in Your Medical Records.

If you lack health history proving that you were injured, your claim might get dismissed since you won’t be able to confirm that you qualify for payment in damages.

When You Have an Old Medical Condition

In a situation where you have an old medical issue, the company may assert that it’s the ailment, not the mishap, that caused your injuries and agony. If the accident aggravated your health, you might be entitled to recover benefits, but it might be challenging to determine and show what the crash caused and how much of the wounds were pre-existing.

Your Payout May Get Denied When an Insurer Acts in Bad Faith

Admittedly, these are only a few typical grounds for claims denial. If you get a rejection notice, you should contact your insurance provider immediately to determine the problem with your claim and available options to correct it.

When you suspect that these factors don’t relate to your situation, the insurer may be dismissing your claim based on bad faith. Such action indicates that the company fails to fulfill its commitment to settle your claim following the agreement reached with the covered party, either the second motorist or you.

When Can You Seek Professional Help

If your insurance payout is refused, you should consult with a vehicle accident attorney immediately. Your lawyer can assist you in speaking with your insurance carrier, determining the source of the difficulty with your insurance claim, and resolving the issue so that you can receive the funds to which you are entitled.

Have you been in a car accident? Do you require the services of an attorney? Valiant Advocates will connect you with expert lawyers in your region right away. Our network spans numerous states in America, and we’ll match you with an attorney who is ready to handle your case immediately. Call our toll-free number to get started: (800) 910-6668.