Insurance companies play a significant role in personal injury cases, but they don’t always approve claims. Denials can leave injured individuals unsure of what to do next. Understanding common reasons for claim denials can help claimants take proactive steps to address the situation.
1. Incomplete or inaccurate information
Insurance companies may deny a claim if the submitted information is incomplete or inaccurate. Form errors, missing documentation, or inconsistent statements can trigger a denial. Always double-check all forms and provide detailed, accurate information to avoid this issue.
2. Delayed reporting
Insurance policies often require claimants to report an accident or injury within a specific timeframe. Waiting too long to notify the insurer can lead to a denial. In Wisconsin, reporting requirements may vary by policy, so it’s important to act quickly.
3. Lack of medical evidence
Insurers may deny claims if there is insufficient medical documentation to support the injury. Claimants should keep all medical records, treatment plans, and doctor’s notes related to the injury. This evidence helps establish the severity and connection between the injury and the incident.
4. Disputes over liability
Insurance companies sometimes deny claims by arguing that their policyholder is not liable. They may assert that the claimant shares fault for the incident. Wisconsin follows a comparative negligence rule, which means a claimant can still recover damages if they are less than 51% at fault. Understanding this rule can help claimants respond to liability disputes effectively.
5. Policy exclusions
Some claims are denied because the incident falls outside the policy’s coverage. Reading the insurance policy carefully and understanding its exclusions can prevent misunderstandings.
Next steps after a denial
If an insurer denies a claim, claimants should review the denial letter for specific reasons. Gathering additional evidence, such as witness statements or expert opinions, may help strengthen the case. Taking timely action ensures claimants remain eligible for potential compensation. Do not delay in contacting an experienced personal injury lawyer for assitance.