What to Do If Your Personal Injury Claim Was Denied
You’ve been injured in an accident, filed a claim, and expected fair compensation—only to find out that your personal injury claim was denied. It is frustrating, disheartening, and can leave you wondering what went wrong. But a denial does not necessarily mean the end of the road. Here’s what to do next if your personal injury claim was denied.
Understand Why Your Claim Was Denied
The first step is to review the denial letter or explanation of benefits (EOB) provided by the insurance company. Common reasons for a claim denial include:
- Lack of evidence connecting your injuries to the accident,
- Pre-existing conditions being blamed for your symptoms,
- Missed deadlines for reporting or filing your claim,
- Disputes over liability, with the insurer claiming their policyholder wasn’t at fault, and
- Policy exclusions or insufficient coverage.
Knowing why your claim was denied helps determine your next move.
Request a Copy of the Insurance Policy
If you have not already received it, ask for a complete copy of the relevant insurance policy.
This will help you (or your attorney) understand what is under the policy covered, what is excluded, and whether the insurer is acting within the terms of the contract.
Gather Additional Evidence
If your claim denial was due to a lack of documentation, now is the time to collect additional evidence.
Key additional evidence may include medical records and expert opinions linking your injuries to the incident, accident reports, photos or video footage, and witness statements.
You will also want to gather proof of lost income, property damage, or ongoing treatment needs.
Sometimes, a more thorough submission can lead to a reconsideration of your claim.
File an Appeal
Most insurance companies have an internal appeals process. If you decide to appeal your denial, make sure to:
- Adhere to any appeal deadlines,
- Submit a detailed letter addressing the denial reasons, and
- Include all supporting documentation.
This step shows good faith and may resolve the issue without going to court.
Consult a Personal Injury Attorney
If your appeal is denied—or if the initial denial was based on complex legal grounds—consult a personal injury lawyer. A skilled attorney can:
- Investigate the insurer’s decision,
- Negotiate directly with the insurance company,
- File a bad faith insurance claim, if applicable, and
- Initiate a lawsuit against the at-fault party.
Please do not assume the insurance company’s decision is final. An attorney may be able to secure the compensation you are entitled to.
Act Quickly
Personal injury claims are subject to strict deadlines, known as statutes of limitations. In Washington, for example, the statute of limitations for most personal injury claims is three years from the date of the injury.
If you wait too long, you may lose your right to pursue compensation entirely.
Contact Justice Through Compensation for Help
If you or a loved one was injured in an accident, please know that the law firm of Justice Through Compensation is here to help. Our legal team is skilled, experienced, and passionate in their representation. Let us shoulder the burden of an injury claim or lawsuit while you focus on healing from your injuries. Contact us today for the quality legal help you deserve.