If you get hurt in an unexpected accident in Nevada, you may assume that an insurance company will pay for your losses by offering a fair settlement for your valid claim. Unfortunately, recovering compensation for an injury is not always easy without the help of a Las Vegas injury attorney. Insurance companies are notorious for denying valid claims in an attempt to protect their own profits.
What Is a Wrongful Claim Denial?
Not all insurance claim denials are wrongful or unwarranted. There are valid reasons why an insurance company might reject a claim, such as missing information, policy exclusions, missed deadlines, lack of coverage, pre-existing injuries and insurance fraud. A wrongful claim denial means that a submitted claim is valid but was denied anyway, likely in an attempt by the insurance provider to save itself money. Any unfounded claim denial that is driven by a desire to minimize a claimant’s payout or avoid paying altogether is wrongful.
Examples of Wrongly Denied Claims
When an insurance company decides to reject a claim, it must issue a written notice to the claimant explaining the reason why. If the explanation given does not make sense or apply to the situation, this may be evidence of a wrongful claim denial. Examples of wrongful denials include:
- Intentionally misinterpreting the language of a policy to argue that the incident falls outside of the policy’s scope or to cite a “policy exclusion.”
- Arguing that the individual missed a filing deadline or committed another administrative error that invalidates the claim.
- Accusing the claimant of misrepresentation, meaning inaccurate or incomplete information was intentionally provided by the injured party.
- Falsely shifting the blame to the policyholder, the injured party or a third party, even if the evidence suggests otherwise.
- Denying coverage due to an alleged lapse in a policy because of nonpayment or late payment of premiums, even if the policy was active and payments were current.
Insurance companies can use many tactics to try to avoid financial responsibility for an accident. This includes attempting to take advantage of a claimant with recorded statements, delay tactics, lowball settlement offers and groundless liability disputes. It is important to be aware of these tactics so that you can protect yourself during a claim.
What Can I Do About a Wrongly Denied Claim?
If an insurance company wrongly denies your valid claim in Nevada, carefully read the denial letter. Compare the insurance company’s explanation for the rejection with the language of the policy. If you believe the insurer is in the wrong, compile all relevant documents and evidence to support your argument. Contact the insurance company to ask about the denial. You have the right to request an internal appeal, which will send your claim to a different insurance company representative for review. If the denial holds, you can then file a complaint with the Nevada Division of Insurance for an external review by an unbiased party.
The Importance of Hiring an Attorney
Dealing with a wrongly denied insurance claim can be stressful and overwhelming, especially as you are trying to heal from a serious injury. Protect your rights by hiring an experienced personal injury lawyer to help you fight the wrongful denial. Your attorney can challenge the denial through all available remedies and negotiate with the insurer for a fair outcome. If the insurance company is guilty of bad faith, your attorney can help you file a lawsuit against the insurance provider for additional compensation. This may include punitive damages to punish the insurer for wrongful acts or misconduct. For help with a recently rejected insurance claim in Las Vegas, contact Koch & Brim LLP for a free review of your case.