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If you get injured because of someone else’s careless or reckless acts, you can recover financial compensation from the negligent party. You may qualify for payment for your medical bills, lost wages, pain and suffering, and other losses. Unfortunately, insurance companies can make it difficult for claimants to recover the compensation they deserve.
If your personal injury claim gets denied, your case is not over. Contact a Denver personal injury lawyer for assistance appealing the decision.
State law in Colorado requires insurance companies to explain in writing why they are denying a claim. You should receive a letter from the insurer giving a reason for the rejection. Determine if it is something that you can remedy, such as missing paperwork or inadequate proof of your losses. You may be able to respond to the insurer with the required information and resolve the issue.
If the insurance company lists a specific policy exclusion as the reason for claim denial, you may have to explain why your case does not fall under the terms of the provision mentioned. You can contact the insurance company to discuss the denial in more detail. There may be a misunderstanding or miscommunication you can clear up during a conversation to continue your claim.
One of the most common reasons for injury claim denials is missing information. The insurance company may reject your claim and explain that they need more information about the incident or losses, such as medical records, photographs, property damage repair estimates, witness statements, paystubs or a letter from your doctor. You may be able to submit additional records or evidence to remedy the issue.
If an insurance company continues to deny your personal injury claim, you can appeal the decision. There are two main appeals processes: internal and external. Start by contacting the insurer and requesting an internal review. A different claims adjuster or representative will look at your case to determine if the first person denied it in error.
If the internal review leads to the same outcome, you can seek an external review from someone outside of the insurance company. For example, you can file a complaint against the insurance carrier with the Colorado Division of Insurance. They will investigate the matter and may reverse the insurance company’s decision if they find evidence of a wrongful denial.
Finally, you can take legal action against an insurance company for wrongfully rejecting your personal injury claim. The two most popular types of lawsuits are breach of contract and bad faith. A breach of contract means an insurance company has violated the terms of a policy, while bad faith is to treat a client in a way that is unfair, unreasonable or unlawful.
A lawsuit against an insurance company for a wrongful claim denial could lead to compensation for your original damages plus additional money in the form of a fine or penalty against the insurer. For more information or assistance taking legal action after a personal injury claim insurance denial, contact Dormer Harpring for a free case consultation.