The terms in any automobile insurance policy provide details, regarding the location of any accident that should be covered. Adjusters look to those details and others, when seeking a reason for denying coverage of a particular on-road incident.
Possible reasons for dispute, concerning coverage
The responsible driver was not covered by the vehicle owner’s policy. The incident did not take place within the boundaries of the region that was mentioned in the purchased policy.
The claim was not submitted before the filing deadline. The claimant delayed receiving treatment, and failed to mitigate any injuries. Adjuster alleges that injury caused by effects of previous injury, or by effects of pre-existing condition.
Suggested actions for claimants that have received a denial
Ask for a written explanation, regarding the adjuster’s decision. Request inclusion in that explanation of any state laws that the driver has violated. Personal injury lawyer in Ajax knows that if the adjuster has failed to honor that request, the claimant should send a written note to the adjuster’s supervisor.
—That note should explain what had transpired up to that point in time.
—In most cases, adjusters cooperate with a claimant, if their supervisor has learned about issuance of a denial.
If the insurance company continues to deny the claim, then the potential claimant ought to speak with a personal injury lawyer.
—The same lawyer should be able to determine whether or not the insurance company might be sued for bad faith.
—If there appeared to be grounds for such an action, the attorney could file a complaint with the proper state authorities.
The lawyer’s role in meeting the timeline for the suggested procedure
Each insurance company sets its own timeline for pursuit of reversal in an effort to deny a claim. The details of that timeline could be buried in the information in the policy, or in the letter that gets sent to any of the denied claimants.
It could prove difficult for the average man or woman to sort through all the details, and to discover the deadline for submitting an appeal. The same task would not be as difficult for a personal injury lawyer. That is why smart claimants make a point of retaining such an attorney.
Moreover, even if the deadline has been met, the task of fighting a denial could pose quite a challenge. The argument presented to the insurance company must be a strong and verifiable one.
By the same token, any lawyer representing a denied claimant/client should demand strong and verifiable evidence in support of any counter-argument. Lawyers that understand how to make such a demand provide their clients with the strongest assurance of a chance to overturn the adjuster’s decision, regarding any policy-linked coverage for their claim.
