Why Do Insurance Companies Deny Claims?

If you’ve been injured in an accident, it’s important that you seek medical treatment right away. Delayed medical treatment may result in further health complications and permanent damage. Some people fear the idea of racking up hospital bills only to have their injury claim denied by an insurance company. 

If your injury was caused due to the negligent actions or omissions of another person or company, they are legally responsible for covering the cost of your injuries. Even if there isn’t another party at fault, your own insurance companies, whether it be a property and casualty insurance company or your health insurance company, may provide coverage to help pay for your medical bills. 

In order to avoid having to pay for costly medical expenses, it’s important to understand the reasons insurance providers use to deny injury claims. 

Common Reasons for Injury Claim Denial 

Like we said before, it’s important that you seek medical treatment immediately. In fact, delaying treatment can actually result in a claim being denied. The insurance company may doubt that your injuries were caused by the accident in question.  

Similarly, preexisting injuries or illnesses can be used as a reason to deny a claim. If you have a preexisting condition that has symptoms or ailments that overlap with the injury you have suffered, an insurance company may argue that the accident wasn’t the cause of your issues.  

An insurance company may cite insufficient proof of injuries to deny a claim. It’s important that you collect detailed information from the medical professionals that you see. Additionally, taking pictures of any visible injuries can help.  

Sometimes, the insurance company will argue that the accident was avoidable, essentially placing the blame on you for your actions. This could include factors such as being drunk or on medication, or it could be that you failed to pay attention to warning signs. This is why you should keep detailed notes of the accident in question, gather statements from any witnesses, and take pictures at the scene of the accident. 

Finally, some people are injured only to discover their insurance has lapsed or expired. Though it might seem like there is nothing to be done about this situation, you may still have options. 

What Can You Do? 

Insurance companies and their adjusters aren’t necessarily out to get you, but it is in their best interest to pay you as little as possible. Even if they don’t outright deny your claim, they may try to underpay it. This can be especially problematic for injuries that require additional ongoing treatment. An insurance company might try to cut you a check before your treatment is actually over. 

If you believe your claim has unfairly been denied or underpaid, you need to act quickly. The sooner you speak to a personal injury attorney, the betterEven in the case of lapsed coverage, you may be able to get reinstated for a fee and still receive coverage.  

Insurance companies are sometimes willing to change the decision to deny a claim when provided with more evidence. Hiring a lawyer can help with that process. 

For a personal injury lawyer in Hamilton and Cincinnati, Ohio, contact The Richards Firm today. Your initial consultation is free, which means you should call us if only for peace of mind. During your consultation, we can learn more about your situation, help you organize your options, and ultimately suggest next steps to you. 

A denied claim doesn’t have to be the end of the story. Contact The Richards Firm and take control of your situation.  Choose justice with a family approach.