What to do When Insurance Denies Your Claim?

One of the first things a person should do after being involved in an accident is report the incident to his or her insurer. Depending on the circumstances of the case, an accident victim will go on to file a claim with either his or her own insurer or the other party’s insurer. In some cases, insurance companies immediately approve the claim and help cover the cost of repairs and medical bills. However, some claims are denied, which can leave accident victims with no safety net. Fortunately, those whose claims have been denied are not without recourse.

First Party Claims vs. Third Party Claims

There are two main types of insurance claims, which are known as first party and third party claims. First party claims are those that are filed with your own insurance company, while third party claims are filed with another person’s insurer. The type of claim that an accident victim files depends primarily on who was at fault in the accident. Although all of those who are involved in an accident should report it with their own insurer, they will generally file the claim with the insurer of the person who was at fault.

The Filing Process

After reporting an accident, the injured party will most likely be required to provide information about the accident as well as the extent of his or her injuries to the insurance companies. The insurer will then investigate the claim by speaking with witnesses, requesting an independent medical examination, and looking at any photos of the scene of the accident. At the end of the investigation, the insurer will either offer a settlement claim or deny the claim altogether.

Claim Denials

Claims are denied for a variety of reasons. For instance, a person may have waited too long to file a claim or may have failed to submit the results of a medical examination. On the other hand, the type of accident the injured party was involved in may not be covered under the policy or the damages may exceed the policy’s limits. Fortunately, when claims are denied, the claimant has the opportunity to file an appeal, although the appeals process will differ depending on each company’s standard procedures. If an appeal is unsuccessful, the claimant can appeal the decision to the State Insurance Commissioner or bring an action against the company if he or she believes that the insurer breached its contract, violated the insurance code, or was involved in bad faith insurance practices.

Finally, claimants who have exhausted all appeals, received an unfair settlement, or were involved in an accident with an uninsured driver have the option of filing a claim against the other party in court. By filing a personal injury suit, the injured party may be able to collect compensation for medical expenses, lost wages, property damage, and damages for pain and suffering.

Call Today to Speak With a Seattle Personal Injury Attorney

If you were recently involved in an accident and your insurance claim was denied either by your insurer or the at-fault party’s insurer, please contact Khan Injury Law by calling our office at (253) 528-7369. Our Seattle car accident lawyers are eager to help you today.