One of the most effective ways to reduce injury claim denials is to provide the insurer of the person who is injured with as much information as possible about the accident so they can review the situation to determine responsibility. If the insurer feels that it might be liable for a portion of the claim that you’re making, they’ll provide the information needed to determine the total amount. In many instances, the insurer will tell you how much they think you deserve but will only go so far in providing all of the information about the circumstances of your accident and even less about their opinion about it.
Once the insurance company begins looking at your case for possible denial, they’ll ask some basic questions about your case to determine where their investigation will focus. Their investigation team will not only look at what evidence you have about the accident but they’ll also look at what information you’ve provided. In many cases, the insurer may try to get you to answer questions in writing. In some cases, they’ll try to get you to answer them by phone. If your claim is denied, the insurer will then send you letters asking for more information and further clarifications about your claim. They’ll then either send you an answer to your questions or they will tell you they will not pursue your claim based on your questions and your answers would be “inconsistent” with their policies.
If your claim is denied, the insurer will give you 30 days to appeal the decision. If you appeal and you win, the insurer will then give you the funds to pay for all of your medical care, your lost wages and all other related expenses.
Your best bet in getting a fair settlement is to hire an attorney who specializes in personal injury and who you can work closely with about your case. The attorney will help you be familiar with your rights and will help protect you from the insurance company from trying to take advantage of you at every turn.
If you’re a victim, remember that you are in fact entitled to all possible damages you suffered and you should always contact a personal injury attorney as soon as possible.