If you’ve never filed an injury insurance claim in Indiana before, you likely think it will be fairly simple. You submit proof of injury alongside your bills, and the insurance company pays the bills the way it promised it would when you or the person at fault for the injury purchased the policy.
However, insurance claims are rarely that simple. And, if the insurance company denies your claim, you’ll need to follow Indiana procedures to protect your rights to appeal the decision. Failing to follow these rules could lead to non-payment and total claim derailment. Or, you might suffer unnecessary headaches and challenges in getting your medical bills paid.
Ideally, you would seek a skilled Indiana personal injury attorney to guide you through the process from the start, but especially if you’re seeking an appeal for your claim denial.
Appealing an Insurance Claim Denial
You’ll receive notice of your claim denial via a letter. You should retain this letter as it provides important information for your appeal. Within the letter, you’ll find information about how to appeal and the reason for the claim denial.
You should review the letter with your attorney. Your attorney will then work with you to develop the next steps. After receiving the notice of claim denial, you’ll only have a few weeks to file your appeal.
Your appeal should be in writing and state the reasons why your claim denial was inaccurate. This might include presenting new evidence or more in-depth evidence than you did during your initial claim.
The insurance company will then review your claim again in light of the new information or your appeal letter. You must appeal in writing as this will provide a paper trail for the appeal and show the timeline for when you responded to the claim denial.
What if Your Claim Is Still Denied
If the insurance company still denies your claim after an appeal or is unwilling to pay the full value of your claim, you can file a lawsuit to pursue damages from the insurance company. Lawsuits are generally the last resort when it comes to insurance claims because negotiations are preferable because they are generally faster and cost less.
Your attorney will guide you toward the best next steps based on the circumstances surrounding your claim and your claim denial.
Reasons Why Insurance Companies Deny Injury Claims
If you’ve received a claim denial, you are likely asking why this is happening. The insurance company might list a variety of reasons for denying your claim.
- Insufficient evidence
- Questions about whether your injuries are truly tied to the incident in question, perhaps because you delayed medical treatment
- The insurance company found that you or another party were at fault for the accident
- The incident that caused your injuries was not a covered event under the insurance policy
- You didn’t see a doctor to formally diagnose your injuries
- You failed to notify the insurance company quickly enough
- The claim value exceeds the policy limits
- The insurance coverage has lapsed
Injury victims often find a claim denial to be disappointing and unnerving. You want to get better and move on with your life. But don’t take a claim denial as the final word. You should talk to an attorney immediately to work toward a solution.
Stewart & Stewart offers a team of experts who know how to work through personal injury claims and ensure victims get the financial support they deserve. Schedule your free consultation now to begin your claim denial appeal.