What to do When an Insurance Company Denies Your Claim

Were you involved in an accident and the insurance company denied your claim? Check out this short video to learn what you can do when an insurance company denies your claim.

Hey everyone, my name is Barry and I’m a personal injury attorney in Chicago, Illinois. On this channel you get short videos on the legal topics that affect your life. So if you haven’t already please subscribe to our channel. Now let’s get into the video.

So first of all, I’ve talked a lot on this channel that the auto insurance companies are not on your side. Not the companies and not the adjusters you’re dealing with. I don’t care if it’s a property damage adjuster a medpay adjuster or an injury adjuster. They engage in tactics repeatedly to delay deny and diminish your claim. Why, because insurance companies are all about profits, not good customer service.

So let’s say you were involved in an accident and the company denies your claim, what do you do next? Well, let’s clarify something, your claim can be denied by either your own insurance company (OR) the insurance company for the other party. In either case you have options available to you.

The other insurance company

Let’s start with the typical scenario, you’re involved in an accident and you file a claim with the insurance company for the driver who hit you – who you think is at fault for the accident. They investigate the claim, they interview their insured maybe they take your statement, and then they deny your claim. What do you do?

Well, in this case, you really only have a single option available to you – you file a lawsuit against the defendant (not the insurance company) the person who you think caused the accident.

Now this raises other issues the most pressing being you probably want to find a lawyer to file the lawsuit on your behalf. That might not be that easy because if the insurance company denied your claim it may be that they have good reason to think you were at fault for the accident.

However, not always. In fact, they may just be engaging in typical insurance company tactics that frustrate people so that you give up your claim.

Either way, its ideal to find a lawyer to represent you. But if you cannot find a lawyer, you might have to file suit on your own. Now if this is a small case you probably can file in small claims court. This is a venue that is really suited for people to represent themselves. But if your case is a bigger case with injuries, filing on your own may be daunting. But its your only choice unless you want to drop the thing altogether.

By the way, it may be that the insurance company doesn’t altogether deny your claim but maybe they put a percentage of fault on you – something they do a lot. Why? Cause it saves them money. Well, then you have to decide whether its worth accepting some fault for the accident or filing a lawsuit.

Your insurance company

Ok, let’s switch gears and look at what happens when your own insurance company may deny your claim – or alternatively, offer you very little on your claim. What do you do?

Well first, how might this arise, I usually see it in 2 scenarios: first, you’re in a solo vehicle accident so there’s no other party involved. And your insurance company is offering you a lower amount for your vehicle than you think its worth.

Or second, let’s say you are trying to tap into your uninsured or underinsured motorist coverage because the person who hit you doesn’t have enough coverage to cover your damages.

Well in this case, your own insurance company becomes adverse. They’re going to treat you as such and you should treat them as such.

So how do you appeal an insurance claim denial? First, normally you are not going to ‘file a lawsuit’ against the insurance company. Rather you are going to appeal their decision.

First, if they deny your claim, I would ask for a certified copy of your insurance policy and I would make them spell out for you in writing where the policy states that in this type of situation you don’t have coverage.

If they aren’t offering you enough money, then you will likely have to appeal their decision by filing for what’s called arbitration and you will arbitrate the case.

This is usually set forth in the insurance contract you signed. Note that since this is with your own insurance company this is different. You are not filing a lawsuit but rather going to arbitration.

So the first thing you need to do is ask the adjuster what is required to appeal their decision. And again I recommend getting a copy of the insurance policy so you can see for yourself what is required.

Most likely you are going to have to request arbitration in writing. There will then be timelines you have to follow and documents you need to submit to pursue your claim.

Whatever the process, I recommend following it to a “T” and documenting every step you have to take because if the insurance company can find a way out of paying you they’ll find it.

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