If you were injured through no fault of your own, you should not be forced to bear the cost and expense of your medical bills, lost income, and other out-of-pocket damages not to mention the inconvenience, stress, pain, and disruption of life you experience. You may expect the insurance company of the at-fault party — or perhaps your own insurance provider — to compensate you for these losses.
While this expectation may be legitimate, insurance carriers unfortunately have significant monetary and other incentives to delay, deny or attempt to reduce the value of any claim that comes their way, and they often go to great lengths to do so. Read on to learn a few scenarios under which insurance company might dispute a personal injury claim:
1. Policy Exclusion or Lack of Coverage
If your coverage (or the coverage of the at-fault party) has lapsed, the insurer most likely won’t pay out benefits. Even if the policy is still active, there might be coverage exclusions in the fine print. Some of these exclusions may not be legal, so it’s a good idea to consult with an attorney if your claim has been denied due to such an alleged policy exclusion.
2. Delayed Treatment or Lack of Medical Documentation
As a rule of thumb, you should seek medical treatment as soon as practicable after injury and preferably on the same day. Otherwise, the insurance company might dispute the cause or severity of your injury, or claim that your decision not to seek medical care constitutes a failure to mitigate your damages.
3. Pre-Existing Injury
If the insurance company has reason to believe you’re claiming damages for an injury that existed prior to the incident that caused you harm, they’ll likely deny your claim unless you’re able to prove otherwise. Even if you had a pre-existing injury, you may still be entitled to compensation if the incident caused your condition to worsen or caused a new, different injury.
Were you partially at fault for the injuries you sustained? If so, the insurance company might contend that you should be held at least partially liable for your damages. The state of South Carolina follows a modified comparative negligence rule, which means personal injury claimants who were partially at fault may still be able to recover compensation as long as they were less than 50 percent at fault. However, the financial recovery of the at-fault litigant will be reduced by their own percentage of fault.
Problems or Inaccuracies with Your Claim
Sometimes a claim is disputed simply because the information provided to the insurance company contains errors or contradictions. A seasoned personal injury attorney can handle all correspondence with the insurance company on your behalf so no mistakes are made that would jeopardize your case.
If your personal injury claim has been denied or if you want to give your case the best possible chance of success, turn to Hodge & Langley Law Firm for representation. Call us today at 864-585-3873 or use our Contact Page to schedule a free initial consultation.