What Happens If An Insurer Rejects An Injury Claim?


No one filing an injury claim wants to end up staring at a rejection notice. However, the fact that an insurance company rejected a claim doesn't mean the process is over. A personal injury lawyer can help you explore the following possible options.

Reconsideration

The first order of business is to review the rejection and determine if the insurance adjuster missed something important. Note that this is a fairly low-probability scenario. However, the insurance company will provide you with a letter that explains that the claim was rejected and why this happened.

Your lawyer may contact them and ask them for more details. If something seems amiss about the logic of the rejection, your attorney can bring it to the attention of the insurer.

Lawsuit

If you push forward with the case, you will likely have to sue. Most insurance companies give a lot of thought to rejecting a claim, and they rarely reconsider unless a personal injury attorney can point them to something they got very wrong.

A lawsuit, though, offers some additional opportunities. First, the insurer will need to consider whether they want to spend more money fighting it and possibly losing. Second, you'll have the chance to demand discovery. Especially if there seem to be some missing pieces of evidence in a case, the discovery process may help you bring them to light. Third, if the claim was rejected based on a specific legal argument, going to court will provide an opportunity to get a judge's perspective.

It's common for insurers to reconsider once new evidence emerges. Likewise, the judge assigned to the lawsuit may order the two sides to resume negotiations. It's possible to arrive at a settlement at any point in this process, and that includes after a trial has started. Sometimes an insurance company needs to see the seriousness of a lawsuit so they are motivated to settle.

Pick Another Defendant

In some cases, the insurance company might have a point. You may need to look at a different defendant. For example, someone might have been injured by faulty equipment. The initial claim focused on the parties responsible for maintaining a location, but evidence emerged during the claims adjustment process that the problem was due to a manufacturing defect. In that scenario, a new claim against the manufacturer might be the best option. Note, however, that all of this has to happen before the statute of limitations expires.

About Me

Understanding the Law Can Help Keep You out of Trouble

Like most adults, I always thought I had a good grasp of the basic laws of the country and those of my state. One day I learned that while, of course, I knew the major ones, I didn't even quite understand my local traffic laws. I always obeyed the law, but due to just not knowing about one local traffic law, I ended up facing a huge traffic fine and getting quite a few "points" on my driver's license due to my legal ignorance. I have since became determined to study up on the law, so I don't make the same mistake twice. I have learned a lot already, and I thought I would help others avoid ending up in the situation I did by sharing what I have learned on a blog. I hope I can help you stay out of legal trouble!

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