A woman in Maine reads that her personal injury claim was denied.If you have received a denial for your personal injury claim from your own insurer or a third party’s, you have many options at your disposal. You should always dispute the denial, especially if the injury was severe and the associated medical costs were high.

Disputing the claim denial may involve re-examining the language of the policy or disputing the circumstances as the insurer sees them. A dispute with the insurer of a third party may also involve determining liability for an accident.

You can review all of these dispute avenues for your case with the help of an experienced personal injury lawyer. Here are some of the actions that Lowry & Associates suggests considering after a denial.

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Review Your Policy and the Denial Letter With a Personal Injury Lawyer

A woman in Maine meets with a personal injury lawyer to review her denial letter from her insurance company.Together with your legal advocates at Lowry & Associates, you can review the reasons outlined in your denial letter and compare them to the language of your policy. 

You will want to pay particularly close attention to the parts of your policy addressing benefits and exclusions as the denial could have been caused by the insurer wrongfully interpreting the information you gave them and considering your injuries to be excluded.

Insurance policy contracts are complex and governed by many exceptions and sub-categories. For instance, your car insurance may not cover an accident in your own vehicle if the insurer determines you were performing an errand for your boss that was “within the scope of employment.”

Send a Dispute Letter or Request More Details

Careful analysis of your policy contract and the information in the denial can allow us to help you draft a letter disputing the denial. In this letter, you can state the reasons that the claim should not have been denied. 

Refer specifically to the “statement of benefits” section in your policy to show why your incident should be covered, and review the language of the “exclusions” section to explain how the insurer may have misunderstood some information.

Make your dispute letter as detailed and concise as possible, and leave emotions or irrelevant narratives describing your claims process out of the letter. The personal injury attorneys at Lowry & Associates can help you meet these criteria while interpreting the language of the policy, crafting a convincing argument, and making counterarguments against the reasoning in the denial.

Hire Us Before Agreeing to Arbitration or Pursuing Civil Action

An experienced personal injury lawyer in Maine shakes hands with a client after agreeing to take on their case.

Many insurance policies require you to submit to an arbitration or dispute resolution process to settle your disputed claim. Arbitration decisions are binding, so the knowledgeable counsel of an experienced attorney from Lowry & Associates will give you a distinct advantage. 

You may also decide to file a civil suit against the insurer for breach of contract, bad faith, or erroneous interpretation of liability with third parties. Having one of our personal injury lawyers with you during this process will be vital to your chances of a successful dispute or lawsuit.

If you are currently facing a personal injury claim denial, contact Lowry & Associates now at 207-222-2222 or fill out our free case review form.