Can I Appeal and Overturn a Denied Car Wreck Insurance Claim in Virginia?

Sep 23, 2022 | Auto Accidents

Road triangle warning sign in front of car accident scene

Yes, you can appeal and overturn a denied car wreck insurance claim in Virginia, but you’ll need a lawyer. Once you’ve reached this point, you’ve done what you can on your own. 

You submitted all necessary information and yet still haven’t received compensation for your injuries. While you could write back and challenge the denial, without new evidence or information, it will be hard to get the claim to go through. 

Sadly, this is not an uncommon situation. Insurance companies try to keep costs down, which means paying out little or nothing on claims or challenging victims with claim denials.

So, if you’re facing a car accident claim denial, here’s how a lawyer can help.

Reasons Why Insurance Companies Deny Claims

There can be several reasons why the insurance company is denying your claim, but they might not provide tons of information to help guide you on this. Your lawyer might determine that the claim was denied based on one  or more of the following:

  1. You were driving a car that is not covered under your insurance. This might be because you purchased a new car and omitted to share that data with your insurance company. 
  2. You aren’t a named insured on the policy.
  3. You didn’t pay your insurance premiums and your policy lapsed or expired.
  4. The type of claim you submitted is not a covered event under the insurance plan the insured chose.
  5. You submitted the claim with the wrong insurance company based on who was at fault for the accident.
  6. There is insufficient evidence that the insured is at fault for the claim. The insurance company might be trying to avoid liability for the accident.

 

Types of Evidence in Virginia Car Wreck Claims

The first thing that a lawyer will help with is presenting evidence to prove your claim. This might involve new evidence or just further documentation for evidence you’ve already submitted for your claim. 

  • Medical records
  • Medical bills
  • Police report
  • Photos and videos
  • Witness accounts and statements
  • Expert testimony

 

Simply submitting medical bills isn’t enough. You’ll need to show a clear correlation between the injuries your doctor is treating and the car accident that caused these injuries.

Additionally, the police report might be vague or there might not be a police report depending on how busy the police department was at the time of the accident. If there is no report or the report has limited information, witness accounts become more important. Ultimately, you’ll need to build a case that your claim is legitimate.

The Process to Appeal a Denied Car Insurance Claim

When the insurance company notifies you of the claim denial, it should include information about appealing the decision. This starts with an internal appeal or an appeal that requests that the insurance company review the decision. To do so, you’ll need to take the following steps:

  1. Read the determination letter explaining why the insurance company is denying your claim. This can provide some insights into what to do next.
  2. Request information about the reason for your denial if you did not get the determination letter or if it was lacking the necessary information for you to appeal. Ask about the appeal process.
  3. Gather additional information based on the claim denial cause. This might include proving the medical necessity for your medical care.
  4. Submit your appeal request with all the necessary information and evidence required to finalize your claim. Be sure this information includes everything your insurance company is requiring.
  5. If you need reimbursement quickly, request an urgent appeal. Sometimes this is necessary when a victim can’t receive care due to financial constraints.

 

If this appeal process does not work, you can request an external review. This involves a third party evaluating the evidence and determining whether the insurance company has grounds to deny your claim.

The best course of action is to work with an attorney on your insurance claim from the start. This will help ensure you don’t face an unfair claim denial in the first place and will put your claim on a faster track to a fair settlement. 

Geoff McDonald and Associates offers a team of experienced car accident attorneys ready to help you no matter where you’re at in the insurance claims process. Contact us now.

Geoff McDonald and Associates: 804-888-8888.

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