Being involved in a car crash is stressful enough on its own, but having your injury claim denied by the insurance company can feel like an added insult to injury. When you’ve sustained physical and emotional harm, medical bills are piling up, and you’re counting on your insurance or the at-fault driver’s policy to cover your expenses, a denial can leave you feeling helpless.
But a denied claim isn’t necessarily the end of the road. If your insurance company or the other party’s insurer refuses your injury claim, there are important steps you can take to challenge the decision, protect your rights, and potentially get the compensation you deserve.
Let’s walk through what you should do next.
Common Reasons Injury Claims Are Denied
Before you react to a claim denial, it’s important to understand why it happened. Insurance companies may deny injury claims for the following reasons:
- Disputing liability: The insurance company might argue that their policyholder wasn’t at fault for the accident.
- Insufficient evidence: Lack of medical records, police reports, witness statements, or clear documentation can lead to a denial.
- Delayed medical treatment: If you waited too long to seek medical care after the crash, the insurer may claim your injuries aren’t related to the accident.
- Policy exclusions or limits: The insurer might state that your injuries aren’t covered under the policy or exceed the policy’s financial limits.
- Pre-existing conditions: If you had a similar injury in the past, they may argue the crash didn’t cause your current condition.
- Missed deadlines: There are strict deadlines for filing insurance claims, and missing them can result in your claim being denied without review.
Understanding the insurer’s stated reason for denial — typically provided in a formal letter — will guide your next steps.
What to Do If Your Injury Claim Is Denied
If your claim is denied, stay calm and strategic. Here’s what you should do:
1. Review the Denial Letter Carefully
By law, insurance companies must give a written explanation when they deny a claim. Review this letter closely to understand the reason. Was it due to a lack of evidence? A dispute over fault? A technicality? Knowing the rationale is essential for formulating your response.
2. Gather Additional Evidence
If your denial was based on insufficient evidence, you might be able to strengthen your claim by collecting more documentation, such as:
- Updated medical records
- A second medical opinion
- Witness statements
- Photographs of the crash scene and your injuries
- Police reports
- Proof of lost wages
Solid, organized documentation can help overturn a denial or support a future appeal.
3. Contact the Insurance Adjuster
Sometimes, claim denials happen because of miscommunication or incomplete information. Reach out to the insurance adjuster handling your case to discuss the decision. Ask for clarification on what additional information they might need and whether reconsideration is possible.
4. File an Appeal
Most insurance companies have an internal appeals process. If you believe your denial was unjustified, you can formally appeal the decision by submitting a written request along with any new evidence you’ve gathered. Be mindful of appeal deadlines, which vary by insurer.
5. Consult a Personal Injury Attorney
If your appeal is unsuccessful, or if the denial involves a complex dispute over liability or medical evidence, consider hiring a personal injury attorney. An experienced lawyer can assess your case, communicate with the insurance company on your behalf, and negotiate a fair settlement. They can also file a lawsuit if necessary.
Most personal injury lawyers operate on a contingency fee basis, which means you won’t pay them unless they win compensation on your behalf.
Can You Sue the Insurance Company?
Yes — if an insurance company wrongfully denies a legitimate claim or acts in bad faith, you may have grounds to sue them. Bad faith practices might include:
- Unreasonable claim delays
- Denying claims without proper investigation
- Misrepresenting policy terms
- Offering unreasonably low settlements
A personal injury attorney can advise whether a bad faith insurance claim or a direct lawsuit against the at-fault driver is the best course of action for your situation.
A denied injury claim after a crash can be frustrating, but it’s not the final word. By understanding why your claim was rejected, gathering strong evidence, and knowing your rights, you can take meaningful steps toward getting the compensation you’re owed. Whether through an appeal, legal negotiation, or court action, you don’t have to face this challenge alone. Seeking professional advice and advocating for yourself can make all the difference in turning a denial into a fair resolution.