How to Challenge a Denied Personal Injury Claim

Many personal injury claimants make the mistake of giving up on their cases if they receive rejection letters from their insurance companies. If your personal injury claim gets denied the first time, you have multiple options for continuing your claim. You may still be eligible for financial compensation. Speak to a personal injury lawyer in Denver for free legal advice in this situation.

Understand the Reason for the Denial

A denial can be frustrating, but don’t give up on your claim. Start by understanding the reason for the rejection. Insurance companies in Colorado are required to notify claimants of denials in writing. Read the rejection letter carefully and contact the insurance company if you need more information.

Common reasons for denials include the insurer disputing liability, stating that there is insufficient evidence, blaming your losses on a pre-existing injury, alleging that your policy has lapsed or there is an exclusion that applies to your claim, or claiming that you missed a deadline. Keep the denial letter to show to an attorney.

Submit Additional Evidence

Many initial claim denials stem from the insurance company needing more information or evidence to process the claim. You can prevent this type of denial by submitting your original claim with the right documentation.

Examples include:

• A police report or incident report
• Medical records related to your injuries
• Photos and videos of the accident scene or injuries
• Written statements from eyewitnesses
• Receipts, bills and other proof of financial losses

You may be able to reverse the denial by sending the insurance company further evidence. Note, however, that requesting excessive evidence is a type of insurance bad faith that may be used to delay or wrongfully deny your claim.

Request a Review

If you cannot remedy the issue during a conversation with an insurance company representative or by sending additional information about the incident or your losses, you can request an internal review, meaning a different claims adjuster will be assigned to your case. Be polite but firm during conversations with the new claims adjuster. Write down who you spoke with and what they said.

Make an Appeal

If an informal internal review still leads to a denied personal injury claim, you can take a more formal approach. You have the right to submit an appeal of the denial. This typically includes a written letter sent to the insurer with clear refutation of the reason for the rejection, along with supporting documentation. Contact your insurer to ask about its specific appeals process.

File a Complaint

You also have the right to ask the Colorado Division of Insurance to review the denial. You can submit an official complaint against the insurance company if you are having issues involving your claim. This agency can investigate your insurance complaint and may take action against your insurer for issues such as bad faith.

Hire a Personal Injury Lawyer

Countering a claim denial can be difficult – especially while also dealing with your injuries and medical treatments. Contact an attorney for legal assistance if your claim has been rejected. A lawyer can review your case and communications from an insurance company to explain your options. You can concentrate on your recovery while your attorney handles an appeal for you.