Practice Areas / Insurance Disputes

We have experience with insurance companies that use Bad Faith in denying legitimate insurance claims. An insurance attorney can help determine the status of your claim.

Have you recently filed an insurance claim you thought would be approved? There are countless reasons insurance claims are denied. Some denials are valid, while others are not.

If you’re struggling to understand why your claim was denied, here are 8 possibilities.

1. You didn’t submit your paperwork on time

The number one reason valid insurance claims get denied is because paperwork isn’t submitted on time. Insurance claims have a statute of limitations, after which, a valid claim won’t be approved. Unless the law specifically permits an extension, or without a court order, it’s near impossible to get an extension for filing an insurance claim.

Time limits to file vary based on the insurance type and several additional factors. For example, a personal injury claim will generally have a longer time limit than a medical malpractice lawsuit. However, being injured by a government official will greatly shorten your time limit to file. Also, claims filed on behalf of minors typically have a longer statute of limitations even when the injury is identical to an adult’s claim.

The average time limit for personal injury claims is 2-3 years, however, a handful of states have 4-year limits and a couple have 5-and-6-year limits.

2. Your claim paperwork was incomplete

Incomplete paperwork can get your claim denied. It’s your responsibility to ensure your paperwork is filled out correctly. However, it’s easy to make a mistake or accidentally skip an important question.

If your paperwork was submitted incompletely, your insurance company might not notify you of the problem at all. Or, they might notify you when it’s already too late to make corrections.

3. Your insurance benefits are already maxed out

If your claim should be valid, but you were denied, it’s possible that your insurance benefits are already maxed out. For example, say you have a $15,000 general liability insurance policy for your business and you’ve already received $12,000 in a recent claim. If you file a claim for $10,000 before your policy limits renew, your claim will be denied.

You might be able to file a claim for the $3,000 left on your policy, but if you file a claim for more than the amount available, your claim will be denied and you’ll have to file a new claim for the smaller amount.

4. Your insurance policy was canceled for non-compliance

Sometimes insurance companies make requests that aren’t optional. If your insurance company makes a request and you don’t follow through, your policy might get canceled. You may have submitted a claim without knowing your policy has been canceled.

Getting canceled out of nowhere isn’t unusual. For example, many homeowners end up with canceled policies after failing to perform repairs suggested by their insurance company.

Sometimes it’s not clear whether a suggestion is really a suggestion or a mandatory requirement. If your claim was denied because your policy was canceled, all you can do is find out why you were canceled and avoid the same mistake when taking out a new policy.

5. Your coverage lapsed for a day or a week

Did you forget to pay your insurance bill? Did your credit card expire before you could update your autopay feature? This is a common problem, especially when dealing with auto insurance.

Enrolling in autopay makes life easier, but a missed payment can make your coverage lapse. If you’re involved in an accident while your coverage is lapsed, there’s nothing you can do.

6. You didn’t seek medical attention promptly

Seeking prompt medical attention is always a stipulation for getting a personal injury claim approved. Whether you sustained an injury during a car accident or on someone else’s property, not seeking medical attention tells the insurance company you’re not really injured.

Whether you feel injured or not, it’s advised to seek medical attention as quickly as possible. If your claim has been denied because you didn’t know about your injuries until later on, contact an attorney right away. Some types of injuries don’t show up until time has passed, and an attorney can help you fight your claim denial.

7. You have pre-existing injuries

Insurance companies love denying claims when people have pre-existing injuries or conditions. For example, a person with a neck injury might get denied if they file a claim for whiplash. You can provide all the medical documentation in the world, but without a lawyer, it will be hard to prove your injury would have happened regardless of a pre-existing injury.

8. Your insurance company is hoping you won’t fight your denial

While many denied claims aren’t sinister, sometimes valid claims are denied intentionally. Insurance companies are just like every other for-profit corporation and the fewer claims they pay out, the more profits they keep.

There are unscrupulous insurance companies out there that deny valid claims hoping consumers won’t fight their denial. Your appeal is less likely to be denied when you’re being represented by a lawyer.

Did your valid insurance claim get denied? Contact a lawyer immediately

If your insurance claim has been denied by your insurance company, contact a lawyer for help. While you can fight the denial on your own through an appeal, you might get rejected again.

To get your claim approved, you need a lawyer on your side. Don’t try to battle your insurance company on your own. An attorney is your best chance at winning your appeal and getting the compensation you deserve.