Reasons Insurance Companies Deny Claims

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Categories: Dealing with Insurance CompaniesPublished On: April 16th, 2021

Have you been denied your rightful accident claim by your insurance company? This article explains the legal steps you can take to ensure that you are not denied the compensation you deserve.

Accidents happen every day in the United States, where someone suffers an injury or has damages sustained to their vehicle. Perhaps one of the first pieces of paper or documentation completed is a claim against the driver who is at fault for the accident by their insurance carrier. Such a claim is for compensation for an injury sustained and or repairs for damages and other losses. However, it is no secret that insurance carriers often try to refuse to pay out claims even when such claims are legitimate. When this happens, the average person may not know how to proceed. This article will discuss common reasons used by insurance companies to deny claims.

As with any legal claims, it is of the utmost importance that the paperwork is completed correctly and timeously. This is because some companies have a time limit and require a person to submit specific documents or data within a particular timeframe. When these specific procedures are not followed, denial is almost inevitable. However, it is not wrong to say that insurance company may attempt to delay a claimant’s payment or try to find a way to deny the claim. It is necessary to hire personal injury lawyers in Anchorage Alaska, to seek such payments for compensation in some cases.

Some common reasons insurance companies use to deny claims include the following:

  • Denying fault – one of the key factors in any personal injury case is proving liability[Liability | Wex | US Law | LII / Legal Information Institute (cornell.edu)] of the defendant. When an accident occurs, and a driver is to be determined as being at fault, the at-fault driver’s insurance company must pay the claim. However, when the insurance company cannot pay or does not want to spend, they try to deny the driver’s fault. The insurance company may argue that their client is not responsible for the accident or that the victim is partially responsible for the accident. This may not be limited to general cases. Still, even in instances where a fault is undeniable, the insurance company may explain that the driver was partially at fault. When the argument is won successfully, it may be determined that there is a shared fault in the incident; thus, meaning that only some of the compensation is awarded.
  • Denying the extent of injuries – some injuries are harder to prove because of their nature. For example, whiplash, brain damage or spinal column issues may be challenging to prove. As a result, the insurance company may attempt to minimize the victim’s injuries or try to verify that the victim did not sustain such injuries in the accident or at all. The insurance carriers go as far as enlisting additional medical professionals’ services to try and prove their case. As such, an independent physician may be necessary.

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