Evaluating Your Options
If you assume that, when you have a legitimate claim under an insurance policy, you’ll get a timely and fair payout, it’s likely you’ve never had to file an insurance claim. Here’s the simple truth: insurance companies are for-profit entities that maximize their bottom line by minimizing what they pay out in claims. Most of the employees at an insurance company have a single goal—to use a variety of tactics, including delays, denials, and inadequate settlement offers, to get you to take as little as possible in compensation for your losses. Accordingly, if you suffered a legitimate covered loss and the insurance company initially rejects your claim, you’re in good company.
So what should you do if a claim is wrongfully denied? You may get some personal satisfaction from calling the insurance company and giving them an earful, but it’s unlikely to change anything. Here are recommendations to improve your chances of getting the outcome you want.
Be Sure to Reject Your Claim in Writing
Most insurers do this as a matter of course, but if you’re turned down on the phone, ask the adjuster or your agent to provide the denial in writing, and ask them to specifically state the reason for rejecting your claim. It’s important to understand that many insurers automatically assume their customers will be afraid or intimidated by adjusters or other officials. They may assume you won’t have the willingness or resources to fight the denial. Asking for written evidence is the first signal that you mean business, and it may cause them to reassess your claim. If you are shuttled from one adjuster to another, make certain you write down the name of everyone with whom you discuss your claim.
Pull Together Evidence to Support Your Claim
Ultimately, what’s probably going to change the decision made by the insurance company is hard evidence:
- Pictures taken at the scene of the accident – Get hard copies of pictures that anyone took of vehicle damage, your injuries, road conditions, and weather conditions.
- Witness statements – If you have the names and contact information for people there at the time of the accident, ask them to prepare a statement/affidavit testifying to what they saw. Get the statement notarized.
- Medical records – When you seek any type of treatment, ask doctors and nurses to document everything in writing.
File an Appeal with the Insurance Company
With every insurance company, you can file an appeal asking for a second look at your claim. If you do, provide copies of all the evidence you’ve gathered. If possible, include evidence that directly responds to and contradicts the company’s stated reason for denying your claim.
Hire an Attorney to Be Your Advocate with the Insurance Company
If you appeal and get the same result, it’s time to turn matters over to a professional. It may feel odd, as most (if not all) of your prior dealings with the insurance company have been one-on-one. You may consider your agent a friend and feel like you have a great relationship. Unfortunately, that can be to your disadvantage when you’re trying to get the benefits due you. Your agent may play the “friend” card and leave you feeling guilty about pursuing a payout from a “friend.” When you have a legitimate claim, you need to back away, turn everything over to your lawyer, and treat it strictly as a business matter.
It’s also important to remember that just about everyone at the insurance company will have more knowledge about your rights and the process than you, and they will have the same goal in mind—to minimize your payout. In conversations with agents or adjusters, you may make innocent statements that could be used against you later.
Contact the Experienced Personal Injury Lawyers at Bailey & Galyen
At the law office of Bailey & Galyen, we know that the losses incurred in a car accident can be extensive and may not be fully covered by insurance. For an appointment with an experienced personal injury attorney, contact us by e-mail or call our offices at 844-402-2992. Our phones are answered 24 hours a day, seven days a week.