An injured woman is on the phone with her attorney while reading that her 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.

An injured woman is speaking with her attorney in his office.

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

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. Your denial could have been caused by the insurer wrongfully interpreting the information you gave them, leading them to believe your accident or injuries should 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.” Lots of gray areas like this emerge, and it takes familiarity with contract law to determine where your injury case falls within these gray areas

Send a Dispute Letter or Request More Details

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

You can refer specifically to the “statement of benefits” section in your policy to show why your incident should be covered. You may also 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. Leave emotion 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 counter-arguments against the reasoning in the denial.

A man is shaking the hand of a personal injury attorney after hiring him.Hire a Personal Injury Attorney Before You Agree to Arbitration or Pursue Civil Action

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 can increase your chances of a successful dispute or lawsuit.

If you are currently facing a personal injury claim denial, contact Lowry & Associates now at 207-888-4622 or fill out our free case review form.