What to Do if Your Insurance Company Refuses to Pay Your Personal Injury Claim

Posted On September 28, 2022 Personal Injury by John Allen Phebus

If you have always kept up with your insurance premium payments, you may assume that any personal injury you suffer will be covered – either by your health, car or homeowners insurance. Unfortunately, insurance companies often look out for themselves more than their clients. This can result in your insurance provider refusing to pay your personal injury claim. Here are the steps to take if this happens to you in Arizona.

Stay Polite and Levelheaded

Try to have a logical, rather than emotional, reaction when an insurance company refuses to pay your claim. Don’t get angry, yell at the insurance adjuster or give up. A rejected claim is not the end of your case. You have multiple options available to argue against this decision and potentially recover compensation.

Find Out Why

The first step is to find out why the insurance company rejected your claim. Read the rejection letter carefully and compare it to the language on your insurance policy. The insurer may have a valid reason to withhold benefits, such as a policy exclusion, missed deadline or another requirement that you missed.

If the rejection appears valid based on the circumstances and information available, consult with a personal injury lawyer before assuming that you are ineligible for compensation. You may still be entitled to a monetary recovery through another means, such as a claim or lawsuit against someone else. If you believe the insurance company made a mistake in rejecting your claim, move on to the next step to file an appeal.

Request an Internal Insurance Company Review

If you do not agree with the insurance company’s decision to reject your claim, contact the insurance company and request an internal review. This means that someone else at the insurance company other than the adjuster originally assigned to your case will review the facts and information to determine if the first adjuster made a mistake. If so, the insurance company can reverse the decision and pay for your injuries.

Complain to the Department of Insurance

If the internal review backs up the first decision made to refuse your payout, seek assistance by involving an external source. Contact the Arizona Department of Insurance and Financial Institutions to file a complaint against your insurance provider. Filing a consumer complaint will initiate an external review of your claim and may result in a different decision being made.

File a Personal Injury Lawsuit

If the appeals process does not result in a fair payout for your personal injury claim, you may have no choice but to file a personal injury lawsuit. This type of civil claim pursues compensation from your insurance company – or a third-party defendant – by arguing that you are entitled to benefits due to the nature of the accident. If you or your lawyer can prove that negligence caused your injury, you will most likely receive a judgment award through a lawsuit even if your insurer denied your original claim.

Consider an Insurance Bad-Faith Claim

If the lawsuit concludes that the insurance company should have accepted your claim and given you a settlement to begin with, you may be eligible for additional compensation through a bad-faith lawsuit against the insurance company. This type of lawsuit seeks penalties against the insurance company for failing to handle your claim honestly and in a good faith attempt to resolve the legal matter by requiring it to pay you further compensation for your inconvenience.

Hire a Personal Injury Lawyer for Assistance

Having your personal injury claim rejected by your insurance company is disheartening. However, there are steps you can take to request a formal appeal, file a complaint and seek the financial compensation that you need to move forward. A personal injury lawyer in Arizona can help you with all of these steps in the pursuit of fair financial benefits. If your situation is urgent, a lawyer can request an expedited medical review and appeals process. For more information, contact The Law Offices of John Phebus Glendale Criminal and Personal Injury Lawyer for a free case consultation.