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What are the most common reasons for a denied insurance claim?

On Behalf of | Mar 28, 2023 | PERSONAL INJURY (PLAINTIFF) - Medical Malpractice

After a motor vehicle accident, you file a claim with your insurance company. Of course, you now expect to receive compensation for your damages, right?

Unfortunately, sometimes, your car accident claim may be denied by the insurer for various reasons.

Delayed reporting

You did not report the accident in time. Most insurance policies require you to notify the company within a certain period of time after the accident, usually 24 hours or less. If you fail to do so, the insurer may deny your claim on the grounds that you did not cooperate with their investigation or that you violated the terms of your policy.

Evidence

You did not provide enough evidence. To prove your claim, you need to provide sufficient evidence of the accident, such as photos, videos, police reports, witness statements, medical records, etc. If you do not have enough evidence to support your claim, the insurer may deny it on the grounds that you did not prove your liability or damages.

You are found at fault

Depending on the state where you live and the type of insurance coverage you have, your claim may be denied if you were partially or fully responsible for the accident.

For example, if you live in a no-fault state and have personal injury protection coverage, your insurer will pay for your medical expenses regardless of who caused the accident. However, if you live in a fault-based state and have liability coverage only, your insurer will not pay for your damages if you were at fault for the accident.

Extensive damage

You exceeded your policy limits. Every insurance policy has a maximum amount of money that the insurer will pay for a claim. This is called the policy limit. If your damages exceed your policy limit, the insurer will only pay up to that amount and deny the rest of your claim.

For example, if you have a policy limit of $50,000 and your damages are $60,000, the insurer will only pay $50,000 and deny $10,000 of your claim.

Of course, whatever your insurance company tells you does not have to be the final word. You can fight back by calling an attorney.

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