An Insurance Company Refuses to Pay My Personal Injury Claim: What to Do - The Green Law Firm
August 7, 2020

An Insurance Company Refuses to Pay My Personal Injury Claim: What to Do

An Insurance Company Refuses to Pay My Personal Injury Claim: What to Do - The Green Law FirmWith more and more people moving to Texas and calling the Lone Star State home, Texas roads are filling up at a quick rate. With the growing number of drivers on roads, the risk of car accidents will also increase. Unfortunately, you will likely be involved in at least one car accident in your life. Whether minor or severe, these accidents are often stressful. Physical injuries, financial instability, emotional distress, and more often follow these accidents. These accidents can be even more frustrating when someone else’s careless actions and negligence resulted in your injuries. In these instances, you have the right to file a personal injury claim with their insurance company for compensation.

The at-fault driver’s insurance should cover the costs of the damages you incurred, such as injuries, present and future medical treatments, vehicle repairs, and more. You have a valid right to file a claim. However, in some instances, the other driver’s insurance company refuses to pay for your personal injury claim. When an insurance company denies you damages, you can fight back.

Car accidents are stressful enough. They become even more stressful when the insurance company of the at-fault driver refuses to pay your claim. After all, that compensation is what will help you get back on your feet. You need to pursue this claim, and with the help of an expert car accident attorney, you can do so. The Green Law Firm is here to help you receive the compensation you deserve.

Why Would It Be Denied?

You cannot fight your claim denial unless you understand why an insurance company denied your claim in the first place. If you do not know why or just have a vague idea why, you need to dig deeper to find the reason, and you need it in writing. Insurance claim departments usually send out a letter explaining why they denied your claim. However, if you never received a written explanation, reach out to the claim representative that denied your claim and request a letter detailing the rationale behind their decision.

There are a host of reasons why an adjuster would refuse your claim, such as:

  • The claim department suspects fraud
  • The policy does not cover the nature of the accident, such as the date, time, location, circumstance, vehicle type, or injuries
  • They claim the accident did not cause your injuries
  • The at-fault driver’s insurance policy expired or lapsed, or the insurance company canceled it for non-payment before the accident
  • The insured driver failed to cooperate with the investigation
  • You failed to prove the insured driver was the at-fault party
  • The insurance policy does not cover the at-fault driver
  • A lack of medical records may lead to an insurance company claiming no injury occurred.
  • The insurance company may argue that your injury did not occur during an accident but is a preexisting condition.

These are just a handle full of reasons an adjuster would deny your claim. Remember, claims adjusters work for insurance companies, so they have their best interests in mind. It is their duty to carefully review your claim to determine if there is any validity in its denial. After all, refusing to pay for damages is in the best interest of an insurance company. Always ask for more information about your claim denial.

Hire an Attorney

When an insurance company refuses to pay your personal injury claim, it can make life complicated. You are already reeling from an accident, trying to manage with injuries, medical bills, pain and suffering, and more, and now they deny you the compensation you rightfully deserve. Do not let these companies bully you around. In situations like these, it is in your best interest to hire an experienced personal injury attorney from The Green Law Firm. Our law firm will help guide you through this situation and will fight to ensure you receive the compensation you deserve.

Once an adjuster denies your claim, they often expect you to give up. However, with the help of a trusted personal injury attorney, you can fight back.

Demand an Explanation

As we stated before, insurance companies often send a written letter explaining why they denied a claim. Reach back out and ask for an explanation if they did not provide one. If you know you were not at fault, provide all the evidence you can, including police reports, recorded statements, eyewitness accounts, medical records, and any other piece of evidence that supports your case. If your case does not progress, nor do they give you a valid explanation, contact a personal injury attorney right away.

Your attorney may draft a demand letter, a more formal claim for compensation, detailing what happened in the accident from your point of view. It may include much of the same evidence you already provided, such as injuries and costs of damages, including why the driver was at fault. The insurance company will either provide a specific reason for their denial, reverse their decision, or offer to pay a portion of the damages.

If you or your lawyer suspects that the insurer used improper and illegal practices, an additional claim on those grounds can be filed.

Formal Appeals

Most insurance companies have a formal appeals process, which your attorney may view as a better alternative. This would open negotiation for compensation rather than focusing on a one-sided demand for damages. In many cases, the parties may use arbitration, which is the process of having one or several individuals make a decision about the dispute after reviewing all the available evidence and arguments.

Filing a Lawsuit

While no one wants to file a lawsuit, in some cases, it may be your only option left. If an insurance company has denied both your claim and your attorney’s, filing a lawsuit against them may be the best course of action. However, before you file a lawsuit, you must be completely upfront with your attorney. Make sure that you provided them with all the evidence and are not hiding anything. You must also remember that the cost of a lawsuit may cost more than the damages, which will cost you money in the end. Thoroughly discuss your options with your lawyer before making this decision.

Car accidents are stressful on their own. They often leave you with lasting injuries, mounting medical bills, and months or years of emotional and mental distress. When an insurance company refuses to pay your personal injury claim, things can get even more complicated. You should never let these companies bully you. With the help of the experienced car accident attorneys at The Green Law Firm, we can help you receive the compensation you deserve.


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