When you sign up for an insurance policy, you expect coverage availability when you need it. The claims process, unfortunately, is not as simple as collecting money from a savings account. You must prove certain things to secure rightful benefits, and insurance representatives are often incentivized to keep payouts as low as possible.
Here are some of the most common reasons you may run into a claim denial in Arkansas:
- The insurance company thinks you were responsible. When you look up “what to do after an accident,” most of the articles you find encourage people to avoid talking about fault until after an investigation. If you admit fault or give an insurer a reason to believe you caused or contributed to the accident, the insurer may reject or lower your claim payout.
- You waited to seek medical attention or file a claim. If you are trying to secure insurance benefits for medical coverage, the insurer needs to see a clear correlation between your injuries and the incident. If you wait until a few weeks before taking action, the link between your accident and injury grows hazy. Always seek medical attention and file your insurance claim within the recommended timeframe after an incident.
- Your coverage lapsed. To collect on your insurance benefits, your account needs to remain in good standing. If you do not pay your premium on time, the insurance company can rightfully reject your claim.
- Your coverage does not include benefits for your claim. Some car owners only carry liability insurance, which covers another driver’s injuries and property. For some claims, you may need collision or comprehensive auto coverage to secure maximum insurance benefits.
- The insurance company is acting in bad faith. Insurance companies do reject valid claims on occasion in an act known as “bad faith.” They have no right to do this to customers or those covered under a policy. If an insurer does not address a bad faith mistake promptly, those who carry the insurance policy can take legal action against the insurer.
Avoid Claim Denials and Protect Your Rights with These Tips
Some claims denials are fair, but many reasons for denial take advantage of policyholders. Use these tips to reduce the risk of fighting a claims denial:
- Keep your insurance account in good standing. Review your coverage regularly, and always pay your premiums to ensure you have coverage when you need it.
- Protect your rights after any accident. Record names and details from the scene of the accident. Seek medical attention. Stick to the facts—not your opinion about what happened—and notify your insurance company of the incident.
- Double check claims forms. Whether you are filing a claim for property damage or to protect medical authorizations, double check the forms you submit. Consider requesting preauthorization for procedures insurance may or may not cover before agreeing to the treatment.
- Understand liability after an accident. Liability will determine which insurer pays for an accident. Another driver’s auto insurance, a store owner’s liability insurance, or an employer’s workers’ compensation insurance policy may cover your claim. If you file a claim with the wrong insurer, the company may deny your claim.
- Talk to an experienced Little rock personal injury attorney if something seems suspicious. If you file a claim with any insurer and your valid claim is rejected, or you receive unfair compensation under the policy terms, reach out to an attorney. A personal injury and or accident attorney in Little Rock can help you determine if you have a larger case against an insurer or the person/company responsible for your accident.
Filing insurance claims is never fun, but it should not leave you feeling unprotected. For more information about insurance claims denials and your rights as a beneficiary, contact the Law Office of Thomas G. Buchanan.