What To Do If The Insurance Company Denies Your Claim
November 18, 2025 Posted In Car Accidents,Personal Injury
A claim denial does not mean the end of your Perris car accident case. Many denials can be reversed with the right documentation and a clear strategy.
Check Why the Claim Was Denied
Insurance companies must provide a written explanation for any denial. This letter outlines the reason for the decision and the policy provisions the insurance company believes apply. Common reasons include:
- Alleged lack of coverage
- Missed deadlines
- Insufficient documentation
- Disputes over liability or fault
- Policy exclusions
- Administrative or paperwork errors
Gather Additional Documentation
Many claim denials occur because the insurance company claims there was not enough evidence to support the claim. Strengthening your documentation can help overturn the decision. Useful evidence includes:
- Medical records and doctor reports
- Repair estimates
- Photographs of injuries or property damage
- Injury journals documenting pain and limitations
- Police or incident reports
- Witness statements
- Employment records showing lost wages
The stronger the documentation, the harder it becomes for the insurance company to maintain the denial.
Review Your Insurance Policy
Your insurance policy outlines your rights, responsibilities, and coverage limits. Review the sections related to:
- Coverage exclusions
- Deadlines for filing claims and appeals
- Requirements for documentation
- Claim procedures
Understanding your policy ensures that the insurance company cannot misinterpret it to deny your claim unfairly.
Contact the Insurance Adjuster
Once you understand the denial, contact the adjuster and ask for clarification if anything seems unclear. Stay calm and professional. Ask the adjuster to explain exactly what evidence or information they believe is missing. Take detailed notes. This helps you identify what to submit in the appeal and ensures the insurance company cannot shift its reasoning later.
Appeal the Denial
Most insurance policies allow you to appeal a denial. The appeal involves writing a formal letter disputing the decision and providing supporting evidence. In your appeal, you should:
- State that you disagree with the denial
- Reference the specific reason for the denial
- Provide documents that address the insurance company’s concerns
- Highlight any errors in the insurer’s reasoning
- Request a full reconsideration
Submit your appeal by certified mail or a method that provides proof of delivery. Keep copies of everything.
Watch for Bad Faith Conduct
Insurance companies must handle claims honestly and fairly. When they fail to do so, they may be acting in bad faith. Examples include:
- Ignoring evidence
- Misrepresenting policy terms
- Unreasonable delays
- Failing to investigate
- Pressuring you to accept an unfair settlement
Bad faith conduct may entitle you to additional damages.
Consider Filing a Complaint
If you believe the denial was unjust, you may file a complaint with the California Department of Insurance. This step can pressure the insurance company to review your claim more carefully. State regulators can investigate patterns of unfair treatment, request explanations from the insurer, and ensure that the company follows California insurance laws. This oversight often encourages insurers to correct improper practices and handle your claim more fairly.
When You Should Consult a Perris Personal Injury Attorney
Insurance companies deny claims every day, and many people do not know how to challenge those decisions. A Perris Personal Injury Lawer can evaluate your claim, identify the insurer’s errors, gather evidence, and negotiate on your behalf. Contacting an attorney as soon as you have a claim denial can substantially increase your chances of a reversal. Legal representation helps level the playing field and ensures the insurance company follows the law.