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Why Did The Insurance Deny My Claim?

August 28, 2020

After you’ve been involved in an accident that you are certain was not your fault, you may be shocked to hear that your insurance claim from the accident has been denied by the insurance company. Once you’ve received a denial from the insurance claim, you may think that there is nothing more for you to do to get compensation for your injuries and damages. However, many insurance claims are initially denied by the insurance companies only for insurers to ultimately pay out for damages after aggressive negotiation or litigation by a knowledgeable New Jersey car accident attorney. 

If you’ve received a denial from your own or from the alleged at-fault party’s insurer, it is important to understand the reasons why you claim was denied so that you can know how to proceed in fighting the denial and continuing to pursue the financial compensation that you need and deserve.

Reasons Why Insurance Companies Deny Accident Claims

Although you may assume that insurance companies exist to protect us, you cannot forget that insurance companies are, above all else, a business. That means that they need to make a profit; the only way they generate profit is to take in more in premiums than they have in expenses and pay out in claims. Insurance companies are pretty efficient operations, so the only way they can increase their profits is to minimize the amount of money they pay out for claims — this means reducing the value of claims or denying claims outright. When a person filing an insurance claim is not represented by an attorney, the insurance company may believe that they can get away with an outright denial or with offering the person a modest sum of money.

Common reasons that insurance companies cite when denying claims arising from accidents include:

  • You were at fault or partially at fault for the accident — The insurance company may argue that you were in some way at fault for causing the accident; alternatively, the insurance company may deny your claim on the basis of your legal fault, such as if you were intoxicated, or if you drove without a license or insurance when you got into a motor vehicle accident.
  • You failed to timely report the accident — If you wait too long to report the accident, such as obtaining a police accident report or filing an accident/incident report with an at-fault business, the insurance company may express doubts about the truthfulness and validity of your claim. In addition, insurance policies often require that claims be filed within a certain time after you incur a loss; filing your claim outside of this time window may give the insurance company a contractual basis to deny your claim.
  • You delayed seeking medical treatment – Similarly, if you wait too long to seek medical treatment for injuries you suffered in the accident, the insurance company may argue that your injuries are really pre-existing conditions or that you were injured by something else after your accident. The insurance company may also argue that you failed to mitigate your damages by seeking prompt treatment so as to not let your condition worsen.
  • Your claim exceeds the policy limits — Insurance companies only agree to cover claims up to a certain dollar amount. If your damages exceed this amount, the insurance company can only offer the policy limit they are contractually obligated to pay. An attorney can help you identify other sources of insurance coverage or compensation that may make up the difference in your damages.
  • The person at fault for the accident is not covered by the policy — If your accident and injuries were caused by someone who the insurance company is not contractually obligated to cover, the insurance company will deny your claim.

If you believe that your insurance claim for compensation following an accident that wasn’t your fault was wrongly denied, you need to speak to an experienced New Jersey personal injury lawyer to go over your options for fighting the denial, such as requesting the insurance company reconsider your claim, or filing suit in court to pursue your personal injury or property damage claim against the at-fault party.

Contact a Morristown Personal Injury Lawyer to Discuss Your Case in New Jersey

Did you or a loved one sustain serious injuries in New Jersey? Don’t let the medical bills pile up while you wait for the negligent party or their insurance company to do the right thing. Right now, you need an aggressive personal injury attorney on your side, fighting to get you the compensation you need, want, and deserve. The skilled attorneys at Hoyt & Hoyt, PC represent clients injured in Morris Township, Montville, Edison, Woodbridge, and throughout New Jersey. Call (973) 292-2299 or fill out our online contact form to schedule a consultation about your case. We have an office conveniently located at 67 East Park Place, 5th Floor, Morristown, NJ 07960, as well as offices in New Brunswick.

The articles on this blog are for informative purposes only and are no substitute for legal advice or an attorney-client relationship. If you are seeking legal advice, please contact our law firm directly.

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