Can I appeal an insurance claim denial?
July 18, 2017
After a car accident, the appropriate thing to do is to make sure everyone involved gets any medical treatment they need in the moment, gather whatever information you can about the accident, and file a claim with the relevant insurance provider or providers.
For many individuals, this is more or less the end of the story, but for others the process may become a burden rather than a safety net. Insurance providers are companies first and foremost, and are therefore keenly interested in saving money where they can justify it. Far too often, they achieve these savings by under-compensating a claim, or in some cases, refusing to pay out for a claim at all.
If you recently received notice that your claim was denied by an insurer, you must consider your next few steps very carefully. Depending on the nature of the claim and the denial, you may have grounds to appeal the decision, but doing so is not a simple process and benefits greatly from proper preparation.
If you did not involve an attorney in your initial claim process, now is probably a good time to do so. The appeal process varies from provider to provider, and any hope of success in these scenarios strongly depends on attention to detail and abiding by fairly strict deadlines. While it is certainly possible to successfully appeal a claim denial without legal guidance, the representation of a lawyer may greatly increase your odds of a successful appeal and even lead to a larger settlement than you might have secured on your own.
Why was your claim denied?
The first step in any appeals process is understanding why the insurance provider denied the claim in the first place. You may face a significantly different appeals process if it was because you failed to submit the claim in the proper timeframe than if it was due to the insurer determining your claim itself lacked proper evidence.
In simple terms, your insurer will inform you why they denied the claim when they inform you of the denial, but there is usually more to know than they can express in a sentence or two. Your attorney can help you evaluate the justification for the denial and identify any weaknesses in your case before moving forward with an appeal.
Build a strong strategy before you launch an appeal
The success of an insurance claim appeal often hinges on the strategy you use to pursue the appeal and your adherence to the insurance provider’s appeals process. For individuals without much experience navigating insurance policies and guidelines, it is easy to lose the forest for the trees in these situations.
Before you officially file any appeal, make sure that you understand the intricacies of the particular provider’s appeals process and that you do everything you can to build a strong case for the validity of your claim. If you believe that strong experienced legal counsel may increase your odds of a satisfying resolution to your claim, do not hesitate to consult with an attorney.