HARO
Reporter: Anonymous
Publication: Anonymous
Interviewee: Josh Damico, VP of Insurance Operations at Jerry
Deadline: 8:00 PM EST – 13 July
What does it mean to have an insurance claim denied?
If an insurance company denies your claim, it means they are refusing to pay for damages or injuries resulting from an accident.
Why would an insurance company deny a claim?
Insurance claims adjusters have control over approving or denying claims. They’ll look at your claim details and verify if your provider does or does not owe you money in your particular situation.
Here are some of the most common reasons for a claim being denied:
- You hit your policy limit. Let’s say you get into an accident (for which you were at fault), and the other driver and their passenger are injured. After treatment, they have $60,000 in medical bills, but you only have $50,000 in bodily injury coverage per accident. Your provider wouldn’t cover the remaining $10,000 as it exceeds your bodily injury coverage per occurrence.
- You don’t have coverage. Let’s say you get into an at-fault accident that ruins your front bumper and headlights. You take your car to the shop for repairs and learn this will cost $3,000. If you don’t have collision coverage, your claim will be denied. If your insurance lapses and you don’t have coverage at the time of an accident, your claim would also be denied.
- You misrepresented policy, driver, or vehicle details when setting up the policy. Let’s say you are using your vehicle to make some extra cash delivering groceries on the weekend and do not notify your carrier of this when you purchased the policy. Your carrier might not cover the claim if they discover you misrepresented or withheld this information while purchasing the policy. For your claim to be approved, everything needs to be reported accurately. An insurance company can deny your claim if anything is misreported, even if the mistakes were unintentional.
- You broke the law. If you were found to have engaged in illegal activity when the accident occurred, your insurance company could deny your claim. This applies even if you were not at fault in the accident.
- You didn’t file your claim promptly. Most insurance providers require you to submit a claim immediately and within a specific time frame. Your provider may deny your claim if you unnecessarily delay filing it. A delayed claim is also a red flag for insurance fraud.
- A driver isn’t on your policy. For example, you excluded your sister from your policy, but she got into an accident with your car. Your insurance wouldn’t cover her.
- Another driver involved is uninsured. If you get into an accident with an uninsured driver and you don’t have uninsured motorist coverage or collision coverage, your insurance would likely deny the claim.
How do you dispute a claim if it is denied?
If your insurance claim is denied, you may still be able to get the payout you deserve from your insurance company. To appeal a claim that’s denied, first ask for a written explanation. From there, you’ll want to gather any documentation or proof you have related to the accident that supports your claim. This includes photos, police reports, communication between you and the other driver, and medical bills. After you gather these together, you’ll need to write a formal appeal to your insurance company. You’ll need to outline why your claim should be approved clearly and the evidence you have to support your reasoning. It is also possible to hire an independent claims adjuster or a lawyer if you believe you are entitled to compensation.
Your insurance rates can increase any time you’re in an accident or file a claim. This can be a great time to shop for a new insurance carrier to see if you can save money. Jerry makes shopping for and switching insurance companies hassle-free.
Can you repair your vehicle yourself?
Whether or not you can repair your vehicle yourself following an accident usually depends on if you own the car and your insurance company’s policies. If you have a loan for it, the lender will require a certified repair shop to handle repairs to maintain the value of their collateral.
If you own the vehicle and your policy allows DIY repairs, the insurance adjuster will typically estimate the cost of repairs, and you’ll be paid out that amount. Even so, keep detailed records and receipts related to your repairs.
How long does it take to receive a claim check?
Contact your insurance company directly to verify the status of your claim. In most cases, you should receive a claim check within 30 days. However, it could be delayed depending on how complex the accident was, if you are dealing with another driver’s insurance company, need to negotiate a settlement amount, or appeal a denial.