FAQ

Why Do Insurance Companies Deny Claims? | Citywide Law Group

You are involved in an accident in Los Angeles. someone else is at least partially at fault for your injuries. You are facing expensive medical bills, repairs to damaged property, and perhaps even a temporary loss of income due to the extent of your injuries. Recovering compensation from the at-fault party’s insurance company should be straightforward. however, this is not always the case.

Insurance companies are not interested in helping you get the money you deserve after an accident. will do everything possible to avoid or limit your payment. many will even deny your seemingly legitimate claim.

Reading: When insurance company denies claim

It is important to consider why insurance companies often deny insurance claims. the answer can be incredibly helpful as you fight for the money you deserve. If you need more help, contact the personal injury attorneys at Citywide Law Group today. we have over 20 years of experience helping accident victims get the money they deserve.

problems with the insurance policy or coverage

Insurance companies will carefully review the insurance policy of the person who caused your accident or injury. companies often reserve the right to deny a claim if there is a problem with that particular policy.

no valid coverage

Insurance companies will only pay if there is a valid insurance policy. Let’s say you suffer a broken bone in a slip and fall accident at a mom and pop little restaurant; pop store los angeles After the accident, the owner agrees to give you their insurance company’s contact information.

However, when you contact the insurer, they find no record of a policy covering that particular store. It turns out that the owner recently opened a new store and didn’t make the necessary changes to his insurance policy. As a result, there is no valid coverage and the insurance company may deny the claim.

cover has expired

Insurance companies will deny claims if they determine coverage has lapsed. There are a few different reasons why insurance coverage can lapse: failure to pay premiums on time, the insurer unilaterally canceled the policy, or the insurance company no longer exists. again, insurance companies will only approve claims when there is a valid and up-to-date insurance policy.

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damage excluded from coverage

Insurance companies will carefully review your claim for benefits to determine the cause of your injuries. all insurance policies contain a list of things that will not be covered. the insurer will deny your claim if it determines that the type of damage you have suffered falls within a policy exclusion. Common examples of policy exclusions include willful acts of vandalism or storm damage.

controller exclusions

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all vehicles registered in the state of california must be covered by a valid insurance policy. however, a valid insurance policy does not necessarily mean that all drivers of a particular vehicle will be covered.

In fact, it is quite common for insurance policies to contain driver exclusion clauses. this simply means that a legitimate policy exists, but certain drivers are not covered. therefore, an insurer may reserve the right to deny her claim if her injuries were caused by a driver not covered by the policy.

controversies about responsibility and fault

Insurance companies will look for any reason to deny a personal injury claim. there are times when the denial has nothing to do with the coverage, but with the circumstances surrounding the accident itself.

cause of contested injury

It is important to provide the insurance company with substantial proof that your injuries are the result of the accident. companies will refuse to approve your request for compensation if your claim lacks support and evidence.

The insurer may justify its denial by claiming that it believes your injuries already existed at the time of the accident or that your own conduct made the injuries worse. always provide clear evidence to link your injuries to your accident.

the extent of his injuries is discussed

An insurer may deny a claim if it believes you have overstated the extent of your injuries. for example, the insurer may not believe that she has suffered a spinal cord injury after an apparently minor car accident. In the opinion of the insurer, this is not the type of injury that typically results from a low-impact crash.

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It is essential to provide detailed information, including medical reports and evaluations, to support your claim for compensation. It is important to provide clear and direct evidence to establish that all of your injuries were the result of the accident.

lack of evidence to establish blame

Insurance claims are often denied if there is a dispute over fault or liability. Companies will only agree to pay you if there is clear evidence that the policyholder is at fault for your injuries. If there is any indication that the policyholder is not responsible, the insurer will deny your claim.

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Claims may also be denied if there is evidence that the policyholder is not solely at fault in an accident. In California, anyone who contributes to an accident can be held liable for any resulting injuries. insurance companies will carefully investigate your accident to determine if you or someone else had a contributing role. If there is evidence that more than one person is at fault, an insurer will likely deny your claim for benefits.

bad faith practices

Insurance coverage exists to ensure that injured victims have resources available after an accident. however, insurance only works when policyholders and insurance companies keep their end of the bargain. If a policyholder purchases coverage and makes payments on time, a company has a legal obligation to genuinely consider any claims that may arise. Unfortunately, some insurers don’t follow the rules and deny bad faith claims.

claims denied without due investigation

Insurance adjusters must exercise due diligence when considering an insurance claim for benefits. this due diligence should include an investigation of the claim and the relevant circumstances. How do you know if your claim was not investigated before it was denied? always make sure the insurer provides a legitimate reason for the denial. The fact that an insurer has denied your claim without justification or reason should be a red flag.

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not filing a claim on time

It is important to act quickly and contact an insurance company as soon as you can after your accident. Most companies place a strict limit on the amount of time you have to file a personal injury claim. In most situations, you will need to file your claim within a “reasonable” amount of time after your accident.

Some companies have specific definitions of what is reasonable, while others do not. Your claim may be denied if the company does not believe that you filed your claim on time. In many cases, this could be a bad faith tactic designed specifically to prevent you from recovering compensation on a legitimate claim.

is not represented by an attorney

Insurance companies will not hesitate to take advantage of you if you are not represented by an attorney. they will suspect that you are not fully familiar with your legal rights and will use it against you. they may unnecessarily delay the processing of your claim or make it difficult for you to speak with a representative.

These strategies are designed to make you buckle under financial pressure and be eager to accept any low offer. You can protect yourself and ensure your claim is handled with the care it deserves by hiring an attorney to handle your claim.

do you need help?

Has an insurance company denied your claim for benefits after an accident in Los Angeles? contact the city legal group for immediate legal assistance. Just because your claim has been denied does not mean your fight for compensation is over. our personal injury attorneys will carefully review your claim and determine why it was denied. Once we’ve identified the reason, we can determine whether it’s best to file an appeal or consider alternative legal action.

We are here to help you get the money you deserve after an accident. We won’t let an insurance company get in your way. Call us to schedule a free consultation with our skilled legal team today.

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