Your Injury Claim Was Denied, What Should You Do?

In Maryland, an at-fault state, if you’re the victim of an accident caused by another’s negligence, you have the right to sue and seek compensation from the liable party or their insurance company. However, what should you do when your injury claim, which should logically be valid, gets denied? This scenario can be quite disconcerting. 

The legal system in Maryland is designed to hold negligent parties accountable for their actions, a principle that makes perfect sense. It ensures the party causing the accident bears the financial burden, while the innocent party avoids inflated insurance costs. This at-fault system typically yields fair results in personal injury cases. However, insurance companies may not always uphold their responsibilities, sometimes denying valid claims and leaving victims in a state of distress and uncertainty.

What should you do if an insurance agency denies your claim? Learn the answer to that question and pick up other useful information pertaining to relevant topics by continuing below.

Why Your Maryland Injury Claim May Have Been Denied

Before we get into the steps you must take if your legitimate injury claim is denied, let’s first discuss why an insurer may issue that denial in the first place. You may be surprised to learn that insurers can cite various reasons when they deny those claims. Some of them are also valid more than others.

They Say Your Claim Is Not Their Responsibility

In certain situations, an insurance agency may reject your compensation claim. This typically occurs when the specifics of your claim fall outside the insurer’s legal obligations. How does this happen?

Well, it could be that the at-fault party’s insurance policy doesn’t adequately cover the accident scenario. For instance, the individual may have opted for an insurance plan that only fulfills the bare minimum legal requirements. As a result, their policy limits might not be sufficient to cover the full extent of your medical expenses and pain and suffering. This can lead to a situation where the insurance company is unable to participate in the payout process as is required due to these policy limitations.

Unbeknownst to you, the driver who caused your accident may also have a lapsed policy. Their coverage expired a few months ago, and they have been driving around without insurance. The law did not catch them in time, and you now have to deal with the consequences of that.

They Notice Mistakes in Your Claim

An insurer can also lodge another valid objection against your injury claim if they notice critical errors in your filing.

One common mistake people make when filing these claims involves providing inaccurate details. The insurance company may find several details in your claim that are inconsistent with the findings of the investigation. They may point to that as proof that your claims are illegitimate and deny your request.

Your error may also be related to the timing of your filing. The state of Maryland gives claimants in personal injury cases three years to submit their lawsuits. An insurer can deny your claim if you go beyond that deadline. The law will side with them, and your claim will likely be dismissed.

They May Dispute Liability

Next, an insurer may reject your injury claim because their client is not obligated to cover your losses. They may state that their client owes you nothing because they are not completely liable for the accident.

The insurance company may state that the facts of the case point to you being responsible. If they can get that assertion to stick, their denial may also hold up in court.

Note that the bar for insurers denying claims based on liability is not even that high in Maryland. That is mainly because the state follows the rule of contributory negligence.

With contributory negligence in effect, a claimant can be barred from recovering compensation if they are found even 1% responsible for an accident. You can count on insurers to lean on that rule to avoid making payouts.

Medical Treatment, Records, and the Extent of Your Injuries

Your actions immediately after your accident can help determine whether you will receive compensation. More specifically, the insurer focuses on how you handled your injuries.

If your medical records reveal that you did not go to a doctor until a few days after the accident, the insurer may point to that as proof that your injuries are minor at most. They may even suggest that you only sought treatment after realizing you have an opportunity to make money.

After examining your medical records, the insurer may also find its contents to be inconsistent with your filing. They may highlight that as evidence that you are embellishing your claims. You may still receive compensation if you file another claim, but the insurer will not provide the amount you originally sought.

They See You Do Not Have an Attorney

Insurers and their representatives regularly deal with numerous claims. Thanks to their experience, they can quickly tell if a claimant lacks the requisite conviction to succeed. They do not even need a valid reason to reject that claim.

The other side may be encouraged to use that tactic precisely because you do not have an attorney. Do not let them get away with that by contacting attorney John Leppler. Give John your denial letter and let him check if the insurer has a valid reason for rejecting your claim. If there is no valid reason for denial, you can confidently move forward with John and demand what is rightfully yours.

What Do I Do if My Maryland Insurance Claim Has Been Denied?

Several months after initially filing your injury, you finally receive a response from the insurer. You are excited by the possibility that your payout is coming soon. However, opening the letter reveals that no such payout is coming your way. Rather than acknowledge that you deserve compensation, the insurer declares that your claim has no merit and rejects it.

That rejection is the last thing you need now that your bills are piling up. So, what can you do after receiving that denial? We have some suggestions regarding how you should proceed.

Hire an Attorney

As mentioned in the previous section, an insurer can deny your claim for a bogus reason, assuming you will accept their verdict and move on. It is a tactic that can work if you do not know what you are doing. Working with a lawyer prevents that tactic from succeeding.

Beyond confirming if an insurer has a legitimate reason for denying your claim, your attorney can also review your filing to see if you made any errors. The next time you file a claim, you can submit a document full of accurate details and valid requests. The insurer will have no reason to reject your claim that second time.

Review Your Insurance Documents

Did your insurer deny your claim? If so, they likely denied your claim because you lacked the necessary coverage.

Look at your insurance documents and confirm if you have the necessary policies. Move forward with an appeal if you believe your insurer made a mistake when rejecting your claim.

Contact the Insurer

The denial letter may feature wording that fails to explain the rejection of your claim. You are trying to grasp what the insurer means but struggling to come up with anything that makes sense.

There is no need to guess why an insurer saw it appropriate to deny your claim. Contact them and request an explanation so you can offer a proper response. Remember to get your attorney involved in that conversation because they can check if the insurer’s reasoning holds water.

Can I Dispute the Insurance Company’s Denial?

Disputing your denied injury claim is indeed a possibility. In some cases, disputing the denial may be your only hope of receiving fair compensation for your losses.

How should you go about disputing the insurer’s decision? Follow the steps detailed in this section of the article if you wish to lodge a successful dispute.

Identify the Erroneous Reasoning Behind the Denial

To start the process of successfully disputing your rejected claim, you must first identify the reason why the insurer made a mistake. Note the reason cited in the denial letter and see if it holds up to scrutiny. If they say that your policy does not apply to your accident, you can ask them to specify how that is actually the case.

You can also refer to the valid reasons for rejecting a claim mentioned earlier in this article. Check if any of them apply to your claim. Proceed with the dispute if all the explanations provided by the insurer have no merit.

Send an Appeal Letter to the Insurer

Once you have ascertained that the insurer mistakenly dismissed your claim, your next step should involve sending them an appeal letter. This appeal letter should clearly state why you believe the initial denial was incorrect. Highlight why your claim is legitimate and offer supporting evidence.

You do not expect insurers to make mistakes when evaluating claims, but they are still human. They are still susceptible to overlooking some important things. Draw their attention to the mistakes they made and reiterate that your claim should be honored.

Compose the appeal letter with your lawyer to ensure it contains all the necessary elements.

Negotiate Your Claim

After receiving and reviewing your appeal letter, the insurer may open a conversation regarding your claim. They may realize you have a valid claim and hope to settle it.

Negotiating a settlement with an insurer is acceptable, but you should let your attorney take the lead during these conversations. They know what a fair offer for your case looks like, so lean on their expertise if you want to snag the best deal possible.

Take the Dispute to Court

You can take your complaint to court and attempt to recover damages that way.

Expressing a desire to take your dispute to court may encourage the insurer to negotiate again. They may even acquiesce to your demands this time. If they do not, you can confidently head to court knowing that you have the truth and an expert attorney on your side.

What Can I Do to Prevent My Claim from Being Denied?

An insurer rejecting your injury claim does not bar you from recovering compensation. Dispute that rejection properly, and you can still secure fair compensation eventually.

Still, it would be better to avoid that initial rejection. So, what can you do to prevent a denial?

You must start by hiring an attorney. We already mentioned this as a tip earlier, but the importance of having a legal expert overseeing your claim cannot be overstated. They can help you avoid costly errors and submit an irrefutable claim.

Seeing a doctor immediately after your accident is also essential. Taking this step shows that you never treated the accident lightly. The insurer is more likely to honor your claim after seeing you display that sense of urgency.

Lastly, do not forget to collect as much evidence as you can. Substantiate all your claims using evidence, and do not allow the insurer to doubt what you are saying.

Experienced Injury Attorney in Baltimore, MD

Feeling overwhelmed after your insurance claim was denied? Don’t scramble for a solution – instead, confidently counter with the expert assistance of Attorney John Leppler. John possesses a keen understanding of insurance claims. He knows how to call out insurance agencies using dirty tactics. He will secure the compensation you deserve by letting the facts speak for themselves.

John can help if you were recently involved in an accident in or around Baltimore City and  Baltimore County. He is an expert in personal injury cases, and he can use that knowledge to your advantage. Reach out to us at Leppler Injury Law today if you are seeking the assistance of an attorney who always prioritizes his clients!