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Main Reasons for An Insurance Denial

Posted on November 3, 2020 in Firm News

If you have never been injured in an accident before, you may not know what to expect from the insurance claims process. You pay your premiums every month and may assume your insurance company wants to help you during a claim. Unfortunately, insurance companies often place profits over people. You may face challenges obtaining fair insurance coverage, including an insurance denial.

Denied Liability

The most common reason an insurance company gives for denying a claim is a lack of liability. An insurance company will only cover damages if it reviews the case and believes it is financially responsible for the claimant’s losses. After a car accident, for example, an auto insurance company will only cover losses if its policyholder was at fault for the collision under Nevada’s fault law. If the insurance company investigates and believes it is not responsible for the losses, it will deny the claim.

Comparative Fault

In some cases, insurance companies deny claims due to alleged comparative fault. Comparative fault, also called comparative negligence, refers to the injured party’s own percentage of fault for the accident. If the insurance company believes you caused or contributed to your own injuries, it may deny coverage. In Nevada, comparative negligence will not bar you from recovery completely; however, it may reduce your available insurance benefits or court settlement award accordingly.

Lack of Medical Evidence

It is critical to go to a hospital right away after an accident in Nevada. One of the key pieces of evidence an insurance company will look for before accepting a claim is medical documentation. If you fail to see a doctor after your accident, you risk the insurance company denying your claim based on lack of proof of injury. Obtain copies of all relevant medical records and bills to submit to the insurance company with your claim after an accident in Las Vegas.

Pre-Existing Condition

While it is important to prove your injuries using medical documentation, it is equally important not to sign a medical authorization form from the insurance company. Insurance companies use this tactic to access claimants’ full medical records rather than only the records related to the accident. An insurance company does this to search for pre-existing conditions that could disqualify the client from coverage. If the insurance company believes the injury you are claiming is pre-existing and not from the accident, it may use this to deny your claim.

Maximum Coverage Exceeded

The insurance coverage available on your claim is not unlimited. It will be subject to the maximum coverage available on the policy. If your claim exceeds the maximum coverage limit, the insurance company may deny benefits. The best way to combat this is to search for other defendants who share fault for your accident. Multiple insurance companies involved in your claim can mean multiple sources of benefits.

Missed Deadline or Form Error

Clerical errors are another common reason for insurance claim denials. If you miss the insurance company’s deadline to bring a claim, for example, you may face a denial. The insurance company may also deny benefits if you made an error on your paperwork, such as failing to provide enough evidence of your losses. The best way to ensure you meet an insurance company’s filing deadline and other key requirements is to hire a personal injury attorney for assistance.

Contact Claggett & Sykes Law Firm About an Insurance Denial

Contact a lawyer from Claggett & Sykes Law Firm right away after a personal injury accident in Las Vegas, Nevada. We can assist you with the insurance claims process from the very beginning of your case to increase your odds of success. If you receive an insurance claim denial, we can investigate the reason for the denial and help you argue for a different outcome. If we suspect insurance bad faith, we can represent you during a claim against the insurance company.