Reasons Why Insurance Company Deny Your Claim

1. Reasons Why Insurance Company Deny Your Claim

2. Insurance can provide peace of mind to people who purchase it to cover injuries in the event of disability. However, after an actual injury occurs, an insurance company may deny coverage for the injury. Below are a list of situations where the personal injury claims can be denied

3. Why Your Injury Claim Would Be Denied • Policy Exclusion • Expiration or Lapse of Coverage • Incorrect or Incomplete Claim • Delay in Treatment • Limited or No Medical Records • Preexisting Condition • Failure to Avoid/Mitigate Injury

4. Policy Exclusion • Certain types of injuries are intentionally excluded from insurance policies. • These exclusions are often hidden in fine print, and certain exclusions may even be illegal. • There are many cases where denials of coverage are based on a technicality that is briefly and vaguely described in the policy.

5. Expiration or Lapse of Coverage • Insurance policy holders sometimes neglect to renew various types of coverage, and coverage is not automatically extended or renewed in most cases. • The insured will usually be out of luck for injuries and losses that occur beyond the expiration date.

6. Incorrect or Incomplete Claim • The person submitting the claim may enter incorrect information, or may fail to comply with claim submission requirements. • Simple mistakes may cause a complete denial of a claim. It is always best to do a thorough investigation into a claim denial.

7. Delay in Treatment • The insurance company may deny a claim because an allegedly injured person did not seek immediate treatment or make an immediate complaint.

8. Limited or No Medical Records • Without medical records, the insurance company may claim that there was no injury at all. • With incomplete records, they may also deny the claim.

9. Preexisting Condition • The insurance company may claim that the injury did not occur on the date of the alleged accident, but is attributable to some preexisting injury or health problem.

10. Failure to Avoid/Mitigate Injury • Injury claims can be denied based on the injured party's failure to avoid the injury or failure to act reasonably to avoid making it worse. • For example, someone who is injured in a car accident but waits a number of weeks before seeking treatment, and then blows off a series of crucial follow up treatments, could be said to have failed to mitigate the injury, and insurance coverage could be denied on that basis.

11. What to do after Injury Coverage Denial • In the context of unwarranted denial of injury claims, it is advisable to first study the insurance policy and then contact the insurance company. • If the insurance company does not provide a valid explanation of the denial, it may be appropriate to contact a personal injury attorney. • Personal injury lawyers offer a free consultation and will be able to explain whether the insured has a strong case against the insurance company.

12. Thanks for Watching Hope this helped Wish to get a quote? Visit us at: https://www.sginjurylaw.ca/about/areas-served/brockville/