What Can You Do if an Insurance Company Denies Your Claim?

If you or somebody you care about has been injured due to the actions of another individual or entity in New Mexico, you should be able to recover compensation for your medical bills, lost wages, property damage expenses, and more. However, what happens if the insurance carrier for the other party denies your claim?

Here, we want to discuss the steps that you can take after the insurance company refuses to pay the claim or decides to pay much less than your claim is actually worth. 

Steps to Take After a Claim Denial

If your insurance claim is denied, you will likely need to work with a personal injury attorney if you decide to fight the denial. There are various steps that you and your attorney will likely take in order to reverse the denial decision by the insurance carrier.

Gathering all available evidence

You and your attorney will need to gather all evidence related to your case. Even though all of this will likely have been examined at this point in the case, your attorney will need to look at everything to make sure that the claim is valid and that it should have been accepted by the insurance carrier. This evidence can include photographs of the incident, video surveillance of the incident, statements from eyewitnesses, medical records, proof of lost wages, and more.

A demand letter

Your personal injury attorney will likely draft a demand letter to send to the insurance carrier. This is a formal claim for compensation that will include various elements. Inside the demand letter, there will be an account of your side of the story, the total dollar amount of damages you have sustained, and an explanation of how the other party was at fault. The insurance carrier will counter with a more specific reason for why the claim was denied, or they may even reverse their decision altogether and pay the claim.

The formal appeals process

Most insurance carriers have a formal appeals process, and your attorney may decide to use this process to work to negotiate a better settlement. This could include the use of arbitration to resolve the issue. Insurance carrier appeals processes can be complicated, and it is crucial for you to make sure you have an attorney by your side when going through these steps.

Possible personal injury lawsuit

In some cases, it may be necessary for you and your attorney to file a personal injury lawsuit against the at-fault party directly. It is important to understand that civil lawsuits can become costly, and an attorney may not want to put a significant amount of resources into a claim that has little chance of succeeding or at least recovering a substantial amount of compensation. However, there are times when the cost of a lawsuit will be worth the effort, particularly for instances of severe injury or when the other party is clearly at fault.

Working With a Personal Injury Lawyer

The best time to secure assistance from a New Mexico personal injury lawyer is very soon after the injury occurs. An attorney can get involved quickly, investigate the incident, gather evidence, and help you recover maximum compensation. When you work with an attorney, it is much more likely that everything will be done correctly the first time, and hiring an attorney will signal to insurance carriers that you mean business about recovering compensation.