After being involved in a collision, filing an insurance claim can help cover expenses related to injuries or property damage. However, if they deny the request, medical and repair costs become your responsibility. To prevent such a financial burden, a car accident lawyer can help you appeal the claim. Here’s what you can expect from the process.

A Guide to Auto Insurance Claim Appeals

Why are claims denied?

Providers typically send denials in the mail and outline their reasoning in the enclosed document. Common examples include a lapse in coverage, policy exclusion, or not enough coverage for the amount requested. They’ll also deny the claim if they suspect fraud or believe it was filed in bad faith, i.e. there’s not enough evidence to support the request. 

Other reasons that a driver’s insurance company may refuse to pay include the policyholder being underinsured and their plan not being high enough to cover the claim. If the driver isn’t listed on the policy of that vehicle, this is also grounds for denial.

What’s needed for an appeal?

Filing an appeal is your opportunity to explain why they’ve made a mistake. However, the burden of proof relies on you and your car accident lawyer. 

The document you submit should outline why the requested amount should be covered and include evidence such as police reports, pictures and videos, medical bills, and repair estimates. Most importantly, the details need to refute the insurance company's reason for denial. 

How is it filed?

The appeal is composed in the form of a letter. Your car accident lawyer will send it and copies of the materials it references, like the auto policy, in the same package. It should be sent to the appropriate party—usually the case adjustor, claim’s agent, or appeal’s agent—and require a signature to ensure it’s delivered. 

What if they deny the appeal?

The next steps vary based on the legality of the case. Some insurance companies have their contracts written to include arbitration requirements. If the claim is denied by your insurance company, then you may have to undergo the arbitration process, which involves presenting the case to a third-party arbitrator responsible for making the decision. 

Alternatively, if the denial is by another party’s company or there’s a personal injury involved, then you can take the case to court. Court-supervised mediation often takes place first, and if the two parties don’t come to an agreement, it goes to a jury trial.

If your insurance claim has been denied, turn to the car accident lawyer at McClure, Ramsay, Dickerson & Escoe LLP in Toccoa. Since 1907, these attorneys have provided dependable guidance and aggressive insurance defense to clients across Stephens County and northern Georgia. Call (706) 989-8471 for a consultation, or visit them online to learn more about their services.