Not all personal injury claims are accepted in Florida if there isn’t sufficient evidence, the victims fail to meet deadlines, or their insurance policies have certain exclusions or limitations. Sometimes, simply failing to follow the claims procedure or inconsistent information can lead to denial.
Suppose you want to file a personal injury claim properly, follow the procedures accordingly, and increase your chances of success. In that case, you should consider looking for an injury-focused law firm in Miami to take on your case. In certain instances, personal injury lawyers can help you even in the event of a denied claim. Here is what you should know about why personal injury claims are sometimes denied in Florida, the rates, and what you can do:
Why Personal Injury Claims are Denied
Regarding claim denial rates in Florida, about 14% of claims are denied since the insurance policy does not cover certain services. In 2021 alone, insurers denied about 17% of in-network claims. Among the most common reasons why personal injury claims are denied are due to the following:
Insurance companies need extensive evidence to support an injury claim. This means that victims must possess proper medical documentation, witness statements, and accident reports. Failure to provide adequate and clear evidence will result in the inability to establish liability or the extent of injuries, leading to a claim denial.
In certain cases, insurance companies can deny claims if a victim has pre-existing conditions. The prime argument for this denial is that the victim’s injuries were not related to the incident and that the pre-existing condition contributed to the injuries. Not all claims where a person has pre-existing conditions are denied. Consult with a personal injury attorney to learn more.
Failure to Meet Deadlines
There are certain deadlines that you cannot skip in Florida if you want to pursue a personal injury claim, such as the statute of limitations. The statute of limitations is the legal timeframe that you have to file a claim. If you file a claim too late, it might not be possible to pursue it any longer. However, there are some exceptions to the statute of limitations, which a personal injury lawyer can help you use if applicable to continue pursuing your claim.
Policy Exclusions or Limitations
Your insurance policy might not cover some circumstances or injuries. These exclusions and limitations can be used to deny your claim. However, you must still ensure that the denial is fair. A personal injury lawyer can help you review your insurance policy and might be able to help you find other legal options to pursue compensation for your injuries and other losses.
In accidents, there is rarely only one party responsible. Insurance companies can use this reasoning to deny a claim or reduce the settlement amount based on the degree of fault assigned to you.
What to Do When Faced With a Personal Injury Claim Denial
If you face a personal injury claim denial in Florida, you should consult with a personal injury attorney to review your case and the reasons behind the denial. Not all denials are just, and you can appeal the decision with a legal professional by your side if the circumstances of your accident and the reason for the denial allow it.