How to Appeal a Denied Car Insurance Claim in California
If you get involved in a motor vehicle collision and you’ve never missed an insurance premium payment or are not at fault, you may assume that your car accident will be covered. Unfortunately, insurance companies find various reasons to reject claims in an effort to protect their own profits. Learn how to appeal a denied insurance claim in California to achieve a fair case result.
Learn the Reason for the Denial
The first step is understanding why the car insurance company has denied your claim. By law, insurers must give the reason for a rejection in writing. Read your rejection notice carefully and compare it to the language on the insurance policy to understand why you may have been denied.
Common reasons for denials are:
- Policy exclusions
- Lapse in coverage
- Issues with the type of coverage
- Missing information
- Lack of injury documentation
- Missed deadline
- Liability disputes
- Violations of policy terms
Contact your insurance company to discuss your case with the adjuster who has been assigned to you. Ask for insights as to why your claim has been rejected. Then, gather as much information as you can about the car accident, including a copy of your police report and detailed medical records. Use this to remedy the reason for the denial, if possible.
Request an Internal Review
If you cannot reverse the insurance company’s decision through conversations with the claims adjuster or by submitting additional documentation, the next step is to request an internal review of your claim. You can do this by drafting a formal, professional appeal letter that contains detailed information about the accident and the evidence you have collected.
Reference the relevant terms of your insurance policy in the letter and officially request the decision to be reconsidered. The insurance company should assign your case to a different claims adjuster for a new review of the facts. Follow up to check on the status of your appeal and keep records of all of your communications with the insurer.
Report the Insurance Company to the Department of Insurance
If an internal review still results in a rejection and you believe you are a victim of insurance bad faith, you can submit a complaint with the California Department of Insurance (CDI). Bad faith means an insurance company is not handling your claim in an honest and good faith attempt to resolve it according to the terms of the policy. Wrongful claim rejections, unnecessary delays and misrepresentation of policy terms are all examples of insurance bad faith.
File a Formal Appeal
If your own complaints and an appeal to the CDI are not successful, consider taking legal action. Contact a top-rated personal injury lawyer in Los Angeles with experience handling insurance disputes. Many of these lawyers work on a contingency fee basis, which means you won’t be charged any fees unless your case results in an insurance settlement or jury verdict.
A Los Angeles car accident attorney can help you file a formal appeal with the courts in your county. This will initiate a lawsuit involving the insurance company that may end in the court requiring the insurer to pay your claim fairly. A lawsuit may involve out-of-court mediation or a court trial. The claim may also reach a settlement at any time before the trial. For more information about appealing a denied car insurance claim in California, contact Rose, Klein & Marias, LLP for a free consultation with a knowledgeable attorney.