What Are the Top 4 Reasons Why Injury Claims Are Denied?

While you have purchased insurance to provide you with that security blanket to ensure when an accident arises that you are covered, not always will your insurer comply with the terms of your policy. Unfortunately, the same goes for the at-fault party’s insurance company as they may also neglect to provide you with the necessary benefits that will cover the costs for medical care, pain and suffering, and any lost wages you would have earned had you not been in an accident. But, insurance claims lawyers in Wayne, Michigan are here to point out some solid reasons as to why these insurance companies deny claims, and what you can do to contest this decision.

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Understanding your insurance policy can help determine if your claim was legitimately denied.

While insurers sometimes provide you with what appears to be a legitimate reason to deny your claim, take a closer look as they too make mistakes just like everyone else. In order to truly identify if a mistake was made on their part, you must know and understand your policy. And while their determination may seem accurate, it is important you conduct your own research to determine if their denial applies to your policy or if they did in fact make an error.

While you take some time to learn the ins and outs of your insurance coverage, below are some of the common reasons why insurers will “justify” why your injury claim was denied.


Exclusions listed in your policy- Although your policy may be a bit confusing, it is vital you understand what types of injuries it is going to cover. If your policy clearly highlights you are granted access to receive coverage for these particular treatments, insurance claims attorneys nearby to you in Wayne, Michigan suggest you call up your insurer and express your concerns.

Your treatment was delayed- While you may have waited to obtain the proper treatment after you sustained an injury, be sure the actual date you visited the doctor is the date the insurer has on file. Many times physician’s offices will report a different date, depending on when they had time to file your claim.

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If your doctor made a mistake on the claim, there is a chance that is why it was denied.

The claim was incomplete– Your doctor’s office may have neglected to write some information on the claim, or even filled it out incorrectly. This can in fact lead to your injury claim being denied, however, it could be a quick fix as well.

Your insurer believes your injury was a preexisting conditionInsurance claim denial lawyers point out that this can become a bit tricky if your insurance company is claiming your injury was caused by something that had already occurred, however, you know this pain and suffering was directly brought on by the accident that transpired.

In the event you are unable to resolve this dispute with your insurer, remember, you can always reach out to a denied insurance benefit law firm in Wayne. An insurance claims lawyer will gladly assist you in trying to get this frustrating matter resolved and you back on your way to recovering from your injuries.

By | 4:17 pm | Categories: Insurance Claims News | 0 Comments

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