What to Do If Your Insurance Claim Is Denied After a Car Accident
Being involved in a car accident is a stressful experience, and a common step for dealing with the aftermath is filing an insurance claim to cover your damages or injuries. However, what happens if you receive a denial letter from the insurance company?
Unfortunately, this scenario occurs more often than many realize and can often feel like a devastating blow. If you're insurance claim is denied following a car accident, it's important to consult an experienced attorney who can help you understand your legal rights and options.
At The Law Offices of Steven Zwick, we understand just how frustrating and overwhelming this situation can be. Our attorneys are committed to helping you step-by-step to understand what to do and file an appeal if your insurance claim is denied in California.
Step 1: Contact an Experienced Attorney
If you’ve received a denial letter, reach out to a California car accident attorney. Always seek legal counsel as a first step and never provide information to an insurance company or speak with an insurance adjuster without an attorney present. An experienced attorney who is well-versed in insurance laws can review your denial letter, evaluate the strength of your claim, and determine the best course of action.
Step 2: Understand Why Your Claim Was Denied
Carefully review the denial letter provided by your insurer. California insurance companies are required to provide a clear reason for the denial, and reviewing this information will help you determine the best course of action. Some common reasons for claim denials include:
Policy exclusions: The damages you are claiming may fall under a clause in your policy that excludes coverage.
Lapsed policy: The insurer may argue that your insurance policy was inactive at the time of the accident, and the company may deny the claim.
Insufficient evidence: The insurer may argue there isn’t enough evidence to support your claim.
Policy limits: The insurer may argue that your damages exceed the applicable coverage limits of your policy.
Liability disputes: The insurance company may argue you were at fault or that another party bears responsibility for the accident.
Understanding the specific reason for denial will help us determine if the insurer acted within their rights or unfairly denied your claim. If you have received a denial letter, contact an experienced attorney as soon as possible.
Step 3: Contact Your Insurance Company
Once you understand why your claim was denied, reach out to your insurance company for clarification with help from your attorney. Politely request further details or supporting documentation related to the denial. This may include information about the investigation, photographs, witness statements, or other materials used to make the decision.
During this process, document every interaction with the insurer, including the dates, times, names of representatives, and details of the conversations. This documentation will be critical if you need to escalate the matter.
Step 4: Correct Any Potential Errors
Sometimes, claims are denied simply due to clerical mistakes or a lack of submitted information. If the denial was based on missing documents, an incorrect statement of facts, or other minor errors, you may be able to correct the issue quickly.
For instance, an insurer may claim they did not receive your medical records or other supporting evidence, even if you supplied them. Resubmitting missing paperwork or correcting errors can often resolve the denial without further conflict.
Step 5: Appeal the Denial
If clarifying details or correcting errors doesn’t lead to a resolution, you have the right to appeal the denial. The denial letter should outline the steps for appealing the decision. Appeals typically involve writing a formal letter to the insurance company explaining why you believe the denial was unjust and including supporting documentation like photographs, police reports, medical records, or repair estimates.
California law requires insurance companies to handle appeals in good faith and with reasonable timeliness. However, successfully appealing a denial often requires a detailed understanding of insurance law. At The Law Offices of Steven Zwick, we have extensive experience handling insurance disputes and can guide you through the appeals process.
Step 6: File a Complaint with the California Department of Insurance
If your insurer fails to act in good faith or you believe the denial violates California insurance laws, you have the option to file a complaint with the California Department of Insurance (CDI). The CDI regulates insurers operating in the state and investigates allegations of unfair practices. Filing a complaint is free and can sometimes pressure the insurance company to resolve the dispute fairly.
Keep in mind that the CDI cannot guarantee a reversal of the denial or force a company to pay your claim. However, their involvement often leads to greater accountability and an impartial evaluation of your case.
Step 7: Adhere to the California Statute of Limitations
It’s important to act quickly when dealing with a denied insurance claim. California has a strict statutes of limitations, which set deadlines for filing appeals, complaints, or lawsuits. Under California law, most car accident-related lawsuits must be filed within two years of the accident date. By consulting with an experienced attorney sooner rather than later, you can make sure all necessary steps are taken within the required timelines.
What to Do If You Suspect Bad Faith?
California has strict laws protecting consumers from unfair insurance practices. Insurers must adhere to the California Fair Claims Settlement Practices Regulations, which require them to handle claims fairly, thoroughly, and promptly. Some common examples of bad faith practices include:
Delaying the claims process unnecessarily
Misrepresenting policy terms or coverage
Failing to conduct a prompt and thorough investigation
Denying claims without a valid reason
Coercing claimants into accepting an insufficient settlement
If you believe your insurer has acted in bad faith, you attorney can help you pursue legal action. Bad faith insurance claims allow policyholders to recover damages not only for the original value of the claim but also for additional losses caused by the insurer’s misconduct. This may include compensation for emotional distress, attorney's fees, and in some cases punitive damages.
How Our Firm Can Help
At The Law Offices of Steven Zwick, we have extensive experience helping clients across Southern California resolve denied claims and disputes with insurance companies. Being denied a legitimate claim after a car accident can leave you feeling powerless, but you don’t have to face this battle alone. Some of the ways our attorneys can help include:
Reviewing your insurance policy and denial letter
Collecting evidence to support your claim
Filing an appeal or complaint on your behalf
Taking legal action if the insurer acted in bad faith
Pursuing compensation after a car accident is your legal right. If your claim is denied, we are committed to helping you pursue the compensation you need while holding the insurance company accountable.
Contact a Skilled Orange County Attorney
If your insurance claim has been denied after a car accident, don’t wait to take action. Contact us at The Law Offices of Steven Zwick today to schedule a free consultation. Our dedicated team is ready to fight for your rights and help you get the resolution you need to move forward.
We proudly serve residents of Anaheim, Brea, Buena Park, Costa Mesa, Cypress, Dana Point, Fountain Valley, Fullerton, Garden Grove, Huntington Beach, La Habra, La Palma, Laguna Beach, Laguna Hills, Laguna Woods, Lake Forest, Los Alamitos, Newport Beach, Orange, Placentia, San Clemente, San Juan Capistrano, Santa Ana, Seal Beach, Stanton, Tustin, Villa Park, Westminster, and Yorba Linda.