Insurance Disputes: What to Do When Your Claim Is Wrongfully Denied
When you suffer a personal injury, you rely on insurance coverage to help you recover damages. However, insurance companies sometimes wrongfully deny claims, leaving injured individuals in a difficult financial and legal position.
If your personal injury claim has been unfairly denied, you must understand your rights and legal options to fight back and recover the compensation you deserve. At The Law Office of George O. Haskell, IV, our personal injury lawyer is equipped to guide you through the process of working through a wrongfully denied insurance claim.
Our Georgia personal injury lawyer is heavily experienced in addressing insurance denials and working on our clients’ behalf to fight for compensation. Here, we'll explore why insurance companies deny claims, how to challenge a wrongful denial, and the steps you should take to resolve an insurance dispute.
Why Insurance Claims Are Denied
Insurance companies are for-profit businesses, and their goal is to minimize payouts whenever possible. Injured individuals are often the victims of these scenarios. If your claim is denied, you may not immediately understand why. Some common reasons for claim denials include the following:
Policy Exclusions
The insurance policy in question may have specific exclusions that limit coverage for certain types of accidents or injuries. For example, some policies exclude injuries related to pre-existing conditions or intentional acts. This can become a roadblock for injured individuals seeking compensation. A skilled lawyer can address these concerns and exclusions.
Disputes Over Liability
The insurance company may argue that their policyholder wasn't at fault for the accident. This could prevent claimants from receiving compensation. Georgia follows a modified comparative negligence rule. This law states that if you’re found to be 50% or more at fault for the accident, you may be barred from recovering compensation, according to Georgia Personal Injury Law Information.
Lack of Medical Evidence
Insurance companies often deny claims by asserting that there’s insufficient medical documentation to prove the severity of your injuries. They may argue that the injuries weren't caused by the accident or that treatment was unnecessary.
It’s essential to keep detailed records of all medical injuries and treatment. Our lawyer can use this documentation as proof that your injuries are severe enough to warrant compensation.
Failure to Notify the Insurer in Time
Most insurance policies require the timely reporting of an accident or injury. If you wait to file a claim, the insurer may deny it, citing a violation of the policy’s terms. If you’ve been injured, it’s important to take steps for compensation as soon as possible. Consulting with our attorney will give you the confidence needed to proceed with your claim.
Disputes Over Policy Limits
If the damages exceed the coverage limits of the policy, the insurer may argue that they aren’t responsible for the full amount of your claim. Our attorney has dealt with this situation before and has the experience needed to fight back.
We’ll protect your claim for compensation for your injuries. Working with insurance companies can be difficult, but our attorney has the experience needed to address this type of denial.
What to Do When Your Claim Is Denied
A wrongful denial doesn't mean the end of your claim. Georgia law provides several options for policyholders and injured individuals to challenge an insurer’s decision. Working with our lawyer means you’ll have someone to represent you in this challenge. We’ve successfully fought back for clients many times and are ready to do so for you.
Review the Denial Letter Carefully
Insurance companies must provide a written explanation of why they’re denying your claim. This letter should outline the specific reasons for the denial and reference policy provisions. Our lawyer will carefully review this document to determine whether the denial was justified. The plan for fighting for your compensation hinges on a clear understanding of why your claim has been denied.
Gather Supporting Evidence
To challenge a denial, you need strong evidence to prove your claim. Our personal injury lawyer is experienced in gathering the proper evidence needed to support your case. We’ll make sure that we explore every avenue for providing evidence for your case. This may include:
Medical records and bills
Accident reports
Witness statements
Photos and videos from the accident scene
Expert opinions (such as medical professionals or accident reconstruction specialists)
When we work on your case, we make sure that your claim is supported and your rights are protected. We’ll work on your behalf to provide the evidence needed for your personal injury claim.
Many individuals are overwhelmed at the prospect of gathering the needed evidence for their claim. Our attorney is experienced in this area and will be sure you have what it takes to challenge an insurance denial.
Appeal the Denial with the Insurance Company
Most insurance companies have an internal appeals process. We can submit a written appeal, providing additional evidence to counter the insurer’s reasons for denial. We’ll be sure to follow the insurance company's procedures and deadlines for appeals. You can rely on our attorney to take a detail-oriented approach to your case.
File a Complaint with the Georgia Insurance Commissioner
If the appeal is unsuccessful, we can file a complaint with the Georgia Office of Commissioner of Insurance and Safety Fire on your behalf. The agency investigates complaints against insurance companies to be sure they comply with Georgia law. A complaint can be filed online or by mail. Our lawyer’s office can advise whether this step is appropriate for your case.
Consider Filing a Bad Faith Insurance Claim
Georgia law allows policyholders to sue insurance companies for acting in bad faith when denying a valid claim. If we can prove that the insurer denied your claim without a reasonable basis, you may be entitled to additional damages, including lawyer’s fees and penalties.
If you think you may be victim to an insurance company acting in bad faith, consult with our attorney. We can assess the situation and advise you on whether we should take action against the insurer.
What Protections Personal Injury Lawyers Provide
When dealing with a wrongful claim denial, a personal injury lawyer can provide crucial assistance in several ways. Our lawyer is well-versed in these types of cases and is ready to consult with you about your situation. We stand up for the rights of our clients against insurance companies that wrongfully deny their personal injury claims.
If needed, we will take the following steps:
Negotiating with the Insurance Company
Our lawyer is a skilled negotiator who understands the tactics used by insurers. We can push back against unjust denials and negotiate for a fair settlement. These types of cases require representation with an understanding of how to fight back when an insurance company denies a claim. Our attorney has spent years standing up for clients in these situations.,
Filing a Lawsuit If Necessary
If negotiations fail, our personal injury lawyer can file a lawsuit against the insurance company for breach of contract or bad faith practices. We approach these cases with the knowledge and understanding that only experience provides. When you choose our attorney, you can rely on us to represent you well.
Maximizing Your Compensation
Insurance companies often rely on claimants giving up or not knowing their legal rights. If your personal injury claim has been wrongfully denied, don’t accept the denial without first consulting a skilled personal injury lawyer. Our experienced personal injury lawyer will work to help you receive compensation for medical bills, lost wages, pain and suffering, and other damages.
Contact Our Personal Injury Lawyer
Standing up to unfair insurance practices is crucial when seeking justice to be served. At The Law Office of George O. Haskell, IV, we’re dedicated to standing up against insurance companies. We serve clients in Macon, Milledgeville, Houston County, Warner Robins, Monticello, and Forsyth. If your personal injury insurance claim has been wrongfully denied, don’t wait. Contact our firm today for representation that protects your rights.