Why Did My Insurance Company Deny My Personal Injury Claim?Individuals invest in insurance for peace of mind in the event of life-altering incidences that are out of their control. While insurance companies are supposed to help in times of great need and stress such as after an accident, burglary, or illness, they oftentimes make it difficult for their customers to file a successful insurance claim. As personal injury lawyers in Tucson, Arizona, we see many individuals whose lives were altered drastically as a result of a serious injury from an accident, yet their insurance companies denied those same individuals help. Why? What can those individuals do about their personal injuries? If you or a loved one were injured due to an automobile accident or other type of accident and if your insurance claim was denied, you are not out of options. Our Tucson personal injury attorneys at Hoffman Law Offices, PLLC work with individuals to receive the compensation and help they need to recover after a debilitating accident left them unable to work, live life comfortably, and enjoy doing the things they love to do. Why Your Personal Injury Claim May Have Been Denied There are several reasons your personal injury claim may have been denied by your Tucson insurance provider, but that does not mean you cannot still receive help. Common explanations for denial of personal injury claims include:
- Policy Exclusion: Insurance coverage is a tricky business, and many insurance plans have such a long list of exclusions and technicalities covered in the fine print that it is hard for the insured to know exactly what they are and are not paying for. If your claim was denied because of one of these exclusions or technicalities, you may have a case, as often the exclusions covered in the fine print are illegal.
- Expiration or Lack of Coverage: Many insurance companies will fail to tell their customers that their plan expired, so that when an individual goes to file a claim, it is denied. Unfortunately, while this is not a fair practice, it is legal, and if this happens to you, you are out of luck for any injuries accrued or any claims filed after the expiration date.
- An Incorrect or Incomplete Claim: Even the smallest of mistakes on your claim form can lead to denial, so if you were denied coverage, be sure to review the denial notice and make sure it did not have to do with a misspelling, wrong date, or empty form field.
- Limited or No Medical Records: If you do not have any medical records after the accident, or if the hospital in which you received treatment did not provide thorough and detailed information about your recovery, your insurance company may deny your claim on the pretense that you never received treatment at all.
- Delay in Medical Treatment: If you did not receive medical treatment immediately after the accident that supposedly caused the injury, the insurance company will deny your claim based off the assumption that the accident had nothing at all to do with your injuries.
- Preexisting Condition: If you suffered from back pain before an accident and then filed a claim claiming severe back pain after an accident, your insurance company will likely tell you that that back pain had nothing to do with the accident. The same goes for any preexisting condition that could be attributed to a prior health condition.
- Failure To Avoid Injury: Insurance providers deny claims if they feel that the customer could have somehow avoided the injury and/or accident altogether. They will also deny a claim if they feel an injured individual waited too long to receive treatment and somehow made the injury worse in that time.
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