What To Do After an Insurance Company Denies Your Claim

Published on May 12, 2023 at 4:46 pm in Personal Injury.

What To Do After an Insurance Company Denies Your Claim

Whether you get hurt as a result of your involvement in an auto accident, a slip and fall, medical malpractice, while using a product, or in some other way, you’re likely to have significant incident-related expenses.

Recovering compensation to pay your outstanding medical bills and for any future health care you might need is important. So too, is seeking reimbursement of any lost wages that mounted while you were hospitalized or at home recovering from your injuries. These are just some of the reasons why injury victims file insurance claims after their accidents—because it’s one of the ways our legal system allows those who are hurt to hold those who cause them harm accountable.

There are situations, however, in which insurance companies push back and reject claims filed by victims. As one example, on the Mississippi Insurance Department website, it details how motorists must have mandatory $25,000 per individual or $50,000 per accident auto insurance coverage. It’s plausible an insurer could deny a claim if the demands for compensation exceeded that amount. They would instead “tender the policy” for the $25,000 allowable and the rest of the financial burden would revert back to the injured party. Thus, the insurer could legitimately be described as partially denying a claim in such an instance.

However, any failures of an insurance company to uphold their legal obligations may constitute a bad faith insurance practice. Our attorneys specialize in handling bad faith cases here in Jackson, MS. As such, our Pittman Roberts & Welsh, PLLC team will explain what to do after an insurance company denies your claim so that you can determine which of these options may be most appropriate to implement in your case.

Determining Why the Insurance Company Denied the Claim

One of the first steps you should take if an insurance company denies your claim is to determine why it happened. While this information is generally contained in the letter letting you know about the denial, the description may be unnecessarily vague. That language may make it challenging to know if the issue is easily resolvable by making a few corrections and re-submitting the claim or if taking a more aggressive stance, such as appealing the decision or filing a bad faith lawsuit, may be in your best interest.

In such instances, it can be helpful to do your best to ask the questions necessary to get to the bottom of the reasons for the denial. It’s likely that the letter will include the insurance company’s contact information; however, if it doesn’t, look it up. Make sure to write down the name of the person you speak with, any associate number they have, and any error codes they may provide, in addition to any other details they provide that would explain why this happened.

Consider Appealing the Claim Denial

Whether the denial seems to have occurred for easily resolvable or downright frivolous reasons, or you simply feel a different set of eyes may view the situation differently, you may want to consider filing an appeal. To do so, you’ll need to collect evidence, which may include additional medical reports or bills, photographs or videos, eyewitness accounts, and virtually anything else that may make liability determinations clearer for the insurer.

You must do more than simply send in that documentation. You need to detail the relevancy of each newly provided document and how it is demonstrative of their insuree’s negligence. Proving liability in auto accidents, slips and falls, and other personal injury situations is seldom easy and thus, having a lawyer assist you in compiling the necessary evidence to put forth a strong appeal can be critical in your case.

Consider Pursuing a Bad Faith Claim Lawsuit

Insurance companies have a few different obligations when handling any claims filed with them. They must:

  • Carefully consider claims before making decisions to accept or deny them
  • Approve valid claims so long as it’s a covered incident, up to policy limits
  • Make timely decisions regarding the acceptance or denial of a claim
  • Offer fair compensation on claims within coverage limits
  • Have a reasonable basis for denying a claim

Failures to meet the obligations described above are just some examples of bad faith tactics an insurer may employ. If you have reason to believe that an insurance company’s following of an unorthodox process in making liability determinations served as the basis for the denial of your claim, it may warrant you escalating the case and filing a lawsuit against them. Miss. Code § 15-1-49(1) gives you three years to do so.

Where a Lawyer Plays Into the Claim Denial Process

Insurance companies aren’t in the business of altruism but instead are money-making ventures. As such, they’ll try to skate liability for those they insure or people their customers injure whenever they can.

While many insurers deny claims for valid reasons, others do so for unlawful ones. They tend to especially deny claims in cases where clients file claims without an attorney’s assistance. Whatever the reason for your claim’s denial, it’s worth your while to discuss your claim with attorneys like ours at Pittman Roberts & Welsh, PLLC that are experienced in handling bad faith insurance claims.

Take time to review our past blog posts regarding reasons why insurance companies deny claims and information widely available on our site about what bad faith insurance claims are to make sense of whether you may have a sound reason for filing a lawsuit. Your initial case review with our Jackson legal team is completely free.

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