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What Are the Top Reasons for Accident Insurance Denials?

Posted in Insurance Companies

If you get injured in an accident in New Mexico, you may be able to recover the costs of your related property damage and medical bills by filing an insurance claim. Unfortunately, an insurance claim can be a difficult process for claimants. Insurance companies are known for making it difficult to obtain benefits. One issue that you may encounter is the insurance company denying your claim. Learn the most common reasons for insurance denials, as well as what to do if your claim gets denied.

Lack of Coverage

If the insurance policy you wish to use does not have enough coverage to pay for the losses and damage being claimed, your claim may be denied or underpaid. After a car accident, for example, if the other driver does not have enough car insurance, you may not be able to obtain the full amount of compensation that you need to pay for your related bills. Carefully read the language of the policy that you plan on using. If you have questions about the type and amount of coverage available, ask the insurance claims adjuster for details.

Missed Deadline

Most insurance companies have time limits on the ability to file claims. The company may require an injured party to file within 72 hours of the accident, for example. This is why it is important to initiate an insurance claim as soon as possible after getting injured in an accident in New Mexico. You may have more time to file if you don’t discover your injuries right away. If you wish to file a personal injury lawsuit in New Mexico, on the other hand, you have two years to bring your lawsuit.

Liability Dispute

It is common for an insurance company to deny a claim due to a liability dispute. If the insurance company investigates the incident and believes that someone other than its policyholder is to blame, it may not accept the claim brought by a victim. You may need to submit further evidence to the insurance company to prove that its policyholder is at fault, or else seek compensation from a third party’s insurance provider instead.

No Medical Evaluation

Always go to a doctor or hospital for professional medical care after a harmful accident in New Mexico. This is important for many reasons, including your physical recovery and the insurance claims process. Many insurance companies look to see if a claimant went to a doctor after suffering an alleged injury; they often ask for copies of official medical records. If you don’t see a doctor, the insurance company may allege that your injury never took place or that it is not as serious as you are claiming. Follow your treatment plan exactly to show the insurer that you did your part to mitigate your injuries and related losses.

Bad-Faith Insurance Denial

An insurance company has a legal responsibility to handle claims and clients in good faith, meaning in an honest attempt to resolve the claim and pay eligible clients in a timely manner. Insurance bad faith refers to an insurance company falling short of this duty, often intentionally to save money on a client’s payout. If the insurer does not give a valid reason for denying your claim, or the reason given does not match your circumstances or the language of the policy, you could be a victim of insurance bad faith.

What to Do if Your Insurance Claim Gets Denied

If your insurance claim in New Mexico was recently denied by the insurance provider, ask for an internal review of your claim by someone else at the insurance company. The analyst may come up with a different response than the first insurance claims adjuster. If not, consult with an attorney for assistance requesting a third-party review.

If this still does not result in an accepted claim, you may be a victim of insurance bad faith. An attorney in Albuquerque can help you file a civil claim against the insurance company in pursuit of compensation for bad faith in addition to compensation for your original claim. Contact a lawyer today for more information about an insurance claim denial.