By Marcus Fernandez
If you’ve recently been involved in a car accident and submitted a claim to your insurance company only to have it denied, you may wonder what your rights are and what steps to take next. While each case is unique, denials can often be contested with the support of experienced legal counsel.
Here’s a comprehensive guide on what to do when a car insurance claim is denied in Florida, including actionable steps, common denial reasons—and what we can do at KFB Law to support you in pursuing your case.
Why Do Car Insurance Claims Get Denied?
At KFB Law, we hear about it all the time: you’ve paid hard-earned money in good faith for insurance benefits, something happens, you need to use those benefits, and the claim gets denied. Understanding the reasons behind that claim denial is essential to forming a strategy.
Determination of Fault
If the insurer believes you were the at-fault party for the accident—for example, they deem that you were distracted and rear-ended another vehicle—your claim may be denied.
Policy Limitations
Your policy may not cover certain claims. If it only covers bodily injury, for example, property damage may be excluded.
Failure to Seek Timely Medical Attention
In Florida, claimants must seek medical attention promptly to verify the connection between the accident and the personal injury claim. Delays can raise doubts, leading to denials.
Pre-Existing Conditions
If the insurer suspects that your injury existed before the accident, this could be grounds for denial.
Lapsed Insurance Policy
Failure to keep up with premium payments can lead to a lapsed policy, invalidating any claims made after coverage lapses.
Exceeding Policy Limits
Claims exceeding your coverage’s limits will likely be denied or only partially compensated.
Policy Exclusions
Your insurance company denies your claim is subject to “exclusions in the policy,” such as an act of God or a natural disaster that may have caused the accident.
Understanding the basis of your insurance claim denial is the first action toward deciding how to move forward.
Steps to Take After Your Insurance Company Denied Your Claim
If your insurance company has denied your claim, we recommend taking the following steps.
1. Review the Claim Denial Letter Carefully
Your insurer is required to provide a detailed claim denial letter, which should include specific reasons and references to policy clauses. Reading this carefully can give you a sense of where to start. In some cases, denials are due to simple errors, like missing documentation or miscommunication.
2. Gather All Relevant Documentation
Collect all the necessary records related to the accident, including medical reports, police reports, photographs of the scene, medical expenses, witness statements, and repair estimates. This documentation can be critical in supporting your appeal.
3. Reach Out to KFB Law for a Consultation
Consulting with a personal injury attorney can provide invaluable insight. KFB Law can review your case, identify additional evidence, and develop a strategic response to the denial from your car insurance company. Contacting a car accident lawyer from our legal firm early in the claims process can improve your chances of success, as we can help gather the necessary documentation and submit a formal appeal.
4. Submit a Formal Appeal
If you believe the denial was unwarranted, you may be able to appeal the decision. A personal injury lawyer from KFB Law will work with you to draft a comprehensive appeal. This appeals process will include:
- A Detailed Account of Your Injuries: This includes medical records and other documentation that connect your injuries to the accident.
- Sufficient Evidence of the Other Party’s Fault (if applicable): Eyewitness statements, police reports, and photographs can help establish liability.
- Documentation of All Related Expenses: This can include medical bills, repair costs, and even lost income.
5. Consider Mediation or Arbitration
Some disputes with insurance companies can be resolved through mediation or arbitration rather than going to court. These alternative dispute resolution options can be a quicker and less costly negotiation fair settlement process, allowing you to present your case in front of an impartial third party.
6. File a Lawsuit If Necessary
If an appeal and other alternatives do not resolve your denial, filing a lawsuit may be the next step. This can be a lengthy process, but it might be necessary to secure fair compensation, especially if the accident caused significant harm.
KFB Law can assist with the legal complexities of pursuing a claim through the court system, ensuring your case is presented with the most robust evidence to seek compensation for damages and injuries.
Avoiding Future Claim Denials: Best Practices
To prevent denials, there are several steps you can take before and after an accident:
Understand Your Insurance Policy
Familiarize yourself with your own insurance coverage limits, policy exclusions, and any other provisions that could affect a claim.
Promptly Report the Accident
Waiting too long to report an accident can work against you. Most auto insurance companies require immediate notification of an accident to ensure a timely investigation.
Seek Medical Care Right Away
Even if you feel fine, it’s essential to be evaluated by a medical professional to document any injuries and ensure you have the evidence needed to support an injury claim. Some injuries do not become apparent until well after the accident, so if a doctor doesn’t immediately assess you, the insurance company may try to say your injuries occurred outside of the accident.
Keep Up With Premium Payments
Make sure your policy stays active by paying premiums on time. Lapses in coverage can void future claims.
Document the Accident Scene Thoroughly
Taking photos, gathering witness contact information, and filing a police report can be instrumental in building a strong claim.
How KFB Law Can Help Fight Your Car Insurance Claim Denial
Insurance companies have deep pockets and extensive resources, making it extremely challenging to navigate a denial of a personal injury lawsuit on your own.
Our personal injury lawyers at KFB Law can assist you with:
- Claim Evaluation: KFB Law will carefully review your case, including your policy, accident details, and denial notice, to identify the most effective course of action.
- Appeal Filing: With the right evidence, KFB Law can submit a well-crafted appeal to the insurance company, highlighting evidence and arguing against any faulty reasoning in the denial.
- Legal Representation: If negotiations or appeals don’t yield results, KFB Law can represent you in litigation, working to protect your rights are protected throughout the legal process.
Get A Free Case Evaluation For Your Denied Car Insurance Claim Today
When your car insurance claim is denied, you don’t have to go it alone. With the assistance of KFB Law, you can take the necessary steps to contest the decision and work toward securing the compensation you deserve.
Don’t let a denied claim stop you, and don’t take on the insurance company by yourself—reach out to KFB Law today to discuss your options. If your insurance claim has been denied and you have questions, contact us today for a free case evaluation.
Note: This article does not guarantee specific results in any claim or legal matter.
