Why do insurance companies deny claims?
There’s nothing more upsetting and shocking when you need to rely on your insurance company or provider, only to find out they have denied your claims. Whether this is business insurance, health care, or malpractice, you could find yourself in a troublesome and worrying place. However, don’t worry; this article will discuss the reasoning behind why these claims could have been denied.
Not submitting your claims in the allotted time frame
Often, paperwork must be submitted in a short allotted time frame following an accident or event. Failure to submit these on time may lead to instant denial. In these instances, you may wish to hire a lawyer to help you through the process, especially if insurance companies or individuals are creating excuses to delay payment.
In the event of an injury where compensation has been requested, an insurance provider may try to minimize injuries as these cannot be seen (e.g. brain damage, whiplash, broken bones). In this instance, it’s important to rely on medical professionals and lawyers to prove these injuries exist and were a result of the other party.
Denial of fault
In some instances, for example, a car accident, the driver at fault’s insurance company may argue the driver at fault was in fact not to blame. Instead, shifting some of the responsibility of the accident to the victim. If the fault is undeniable, partial compensation may only be received.
To prevent or minimize this, you should work with a lawyer and request any medical records or details in advance, if required, to prove your injuries did not exist before the accident. Denial of fault is most prevalent in personal injury cases and is something to be wary of.
The injury, death, or cause was not covered in the policy
Finally, regardless of which insurance policy you have purchased, there may be loopholes. For example, dangerous hobbies leading to death, e.g. sky diving, may lead to an insurance company refusing to pay.
The same applies to failing to disclose personal information or providing false information upon your application (for instance, you had underlying health problems but lied about these).