The victim of an accident that has chosen to file a personal injury claim should not assume that he or she has been guaranteed the satisfaction of receiving some form of compensation.
Possible reasons for denial of claim
Evidence has shown that the driver making the claim had committed a traffic violation during the minutes before the accident. A policyholder made the claim, and the name of the person driving the insured vehicle at that time of the accident did not appear in the purchased policy.
The claim’s attachments did not include a sufficient amount of documentation, relating to the reported injury. The insurance company requires more medical proof of the injury’s existence. The attached medical report failed to provide the insurance company with a complete assessment of the reported injury. The form submitted to the Claims Department had not been filled out properly.
Does it pay to challenge the denial of a claim?
Yes, no injured victim that has purchased an insurance policy should hesitate to challenge an insurance company’s decision to deny the policyholder’s request for coverage. Of course, a policyholder can initiate a stronger challenge if he or she has consulted with and hired a personal injury attorney.
An experienced injured attorney in Richmond Hill might have helped another client that had faced a similar problem. Moreover, an attorney’s skills could prove useful, during those times when it was necessary to communicate with the Claims Department, or with the insurance company’s medical team. That would be the team that reviewed the submitted medical reports.
It could be that the injured victim had reason to expect late-appearing injuries. If some expert could confirm the likelihood for that appearance, then that might push the insurer to reconsider the decision to deny coverage. Yet, an insurer would be more apt to reconsider that action, after being contacted by the policyholder’s personal injury lawyer.
Understand, too, that the reasons given in the above list are considered reasonable, even if any one of them could be challenged. Some reasons,though, fail to have a logical basis. For instance, a policyholder should not be told that he/she has submitted the claim after a given deadline.
There is no deadline for filing a claim, as long as the waiting period has not prejudiced the claim in favor of the injured victim. Sometimes insurance companies imply the existence of a deadline, because there are different deadlines for filing a complaint, in order to initiate a lawsuit.
Lawyers are familiar with that particular tactic. That fact underlines the list of advantages that are enjoyed by anyone that has chosen to hire a personal injury lawyer, after receiving notice of the fact that the Claims Department has denied request for coverage.