Navigating the world of personal injury claims can be a tumultuous journey, fraught with complexities and unexpected roadblocks. One major hurdle personal injury claimants often face is having their claim denied by insurance companies. As heartbreaking as it sounds, it’s a common reality many individuals grapple with, often leaving them in a state of confusion and desperation. In this blog post, we’ll reveal the top excuses used by insurance companies in an attempt to deny or lower the value of personal injury claims. We hope to provide insight and guidance that can help you avoid insurance claim pitfalls.

So, whether you’re just starting your claim, or you’ve already enlisted the help of a personal injury lawyer, having this knowledge at your disposal is invaluable. Strap in as we unravel the often opaque world of insurance claims.

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Why Do Injury Claims Get Denied By Insurance Companies?

Reason 1: Failure to Seek Prompt Medical Treatment

One of the most common reasons insurance companies deny personal injury claims is if there’s a gap between the date of the accident and when medical attention was sought. Insurance adjusters are trained to scrutinize every detail in an attempt to discredit your claim. If you wait too long before seeing a doctor, they’ll use this as an excuse to argue that your injuries weren’t a direct result of the accident. To avoid this, make sure to seek medical treatment as soon as possible after an accident, even if you don’t feel any immediate significant pain or discomfort. Tell your doctors each and every body part that hurts and describer the type of pain to them.

Reason 2: Discrepancies in Medical Records

Another tactic used by insurance companies is to compare your medical records from your different providers. If there are any what appear to be discrepancies, they’ll use this to question the legitimacy of your claim. It’s important to be consistent when describing your injuries and symptoms to medical professionals, and to seek treatment from a reputable doctor or specialist. It should be noted there are always “discrepancies” is treatment records as not all doctors and nurses use the exact same language when documenting a medical encounter and sometimes the medical providers simply make mistakes, especially when they are filling out a medical record hours after they saw the patient or for any other of several reasons.

Reason 3: Pre-Existing Injuries

Insurance companies often try to argue that your injuries were preexisting and not caused by the accident. They will request access to your medical history, looking for any previous injuries or conditions that could be used against you. It’s important to disclose any preexisting injuries or conditions to your doctor and personal injury attorney, as they can help document a case that proves your current injuries were exacerbated by the accident, even if you did have any pre-existing condition.

Reason 4: Lack of Evidence

Insurance companies are notorious for denying claims due to a lack of evidence. This is why it’s crucial to gather as much evidence as possible after an accident, including witness statements, photos, and police reports. Without solid evidence, insurance companies can argue that the accident didn’t occur or that your injuries were not as severe as you claim.

Reason 5: Failure to Follow Doctor’s Orders

If you fail to follow your doctor’s recommended treatment plan, insurance companies may use this as a reason to deny your claim. They may argue that your injuries were not as serious as you claim or that you didn’t take proper steps to recover. It’s important to follow all medical advice and document any missed appointments or treatments.

Reason 6: Lack of Legal Representation

Insurance companies know that individuals without legal representation are more likely to accept a lower settlement or give up on their claim altogether. Having an experienced personal injury lawyer by your side greatly increases your chances of success and helps to ensure that you receive the full compensation you deserve.

Reason 7: Statute of Limitations

Each state has its own statute of limitations for personal injury claims, which is the time limit within which a claim must be filed. If you miss this deadline, insurance companies can use it as a reason to deny your claim. It’s important to file your claim as soon as possible after an accident and be aware of the statute of limitations in your state.

Conclusion

While dealing with insurance companies may seem like an uphill battle, understanding their tactics and having a knowledgeable personal injury litigator on your side can make all the difference. By avoiding these common pitfalls, you can increase your chances of a successful claim and receive the compensation you deserve for your injuries. Don’t let insurance companies deny you justice – arm yourself with knowledge and seek professional legal assistance to help navigate this complex process.

Would you like to speak with a seasoned civil litigator who knows how to deal with stubborn insurance companies? Contact the law office of Craven, Hoover, and Blazek P.C. at 317-881-2700 to set up a free case evaluation with an experienced accident claim lawyer in Indianapolis, Indiana. We represent personal injury claimants all across the state, including Indiana residents injured in other states. No need to travel – we gladly provide the option to hold meetings by phone, at your residence, online, or at the hospital if necessary.

How Personal Injury Lawyers Get Paid

Many law firms that specialize in personal injury work on contingency, meaning they will represent a client and handle their case for free, initially, and only collect lawyer fees if they obtain a settlement for their client. If they cannot settle, and fail to recover a judgment in court, the law firm does not get paid and loses the expense money the law firm spent on pursuing the claim.

For this reason, it is important for personal injury lawyers to take on cases that have a strong chance at being successful. If a victim of a personal injury has a claim that is not strong enough to win a settlement or judgement in the attorney’s opinion, a law firm may choose to pass on representing that potential client, and in doing so, refer them to other sources.

On the other hand, if the client insists on pursuing a claim that they could win but is not as strong as other cases, a lawyer may agree to do so in exchange for an upfront, non-refundable fee. So what makes a case weak? And why do lawyers pass on certain cases and personal injury claims? There are several reasons why a personal injury law firm might decide to not take on a case or to take on the case but have the plaintiff pay some of the up-front expenses.

Accepting and Passing on Personal Injury Claims

In order for a victim of a personal injury to successfully win a settlement for their damages, they must prove that they were injured as a result of another’s negligence or carelessness, that person had a certain duty of care to prevent such accidents, and more. There are several laws and stipulations that regulate these boundaries of negligence and fault, all of which vary among states, and personal injury lawyers are extensively well-versed in each of them. If they review a case that seems to have flaws or holes within it or a case where the evidence that once existed no longer exists, they may not see value in representing the client because the case is weak.

For example, if a person is injured in a motor vehicle accident because the opposing driver failed to stop at a red light, they likely have a valid case at first glance. A lawyer will assess whether or not the injured driver followed and obeyed all traffic signals and laws; and in the case they did, a lawyer will most likely agree that they were injured as a result of direct negligence and is entitled to compensation for their damages. In this situation, a personal injury attorney would most likely accept this case and represent this client for free, only collecting lawyer fees if they recover a settlement. If there is a witness stating the opposing driver ran the stop light, obviously the case and evidence would be even stronger and worthwhile pursuing.

Speaking with Different Attorneys

If you call and discuss your potential case with an attorney and they decide not to represent you, it is important to speak with different attorneys for their thoughts on the pros and cons of you potentially pursuing a case. Some attorneys will only represent a personal injury claimant who has undeniable evidence of negligence of the opposing party. Other law firms will represent a personal injury claimant who has strong evidence but not undeniable evidence.

Craven, Hoover, & Blazek P.C.

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Top Reasons Insurance Companies Deny Personal Injury Claims