How to Appeal an Insurance Claim Decision in Fort Myers

An insurance claim decision that denies you financial assistance to pay for lost wages, vehicle repairs, and medical bills is not the only thing that frustrates you. Far too many auto insurance companies do not respond to auto insurance claims with a sense of urgency. For years, Fort Myers residents, as well as residents throughout Florida, had to wait a long time before receiving a decision on a car insurance claim.

The amount of time an insurance company has to settle a claim depends on the type of claim filed. For a general insurance claim, an insurance company must investigate and then decide on the status of a claim within a “reasonable period.” The problem with the term “reasonable period” is the term leaves the door open for insurance companies to delay investigating claims. However, most auto insurance companies follow the 30-day rule used for PIP claims to decide the status of general car insurance claims.

The bad news sent to you by your insurance company arrives in the form of a claim denial letter. Within the claim denial letter, the adjuster who investigated your claim states the factors that led to the denial of your claim. You should read the entire claim denial letter to understand why the claim adjuster assigned to your case did not approve your claim for financial assistance.

Insurance companies have the option to send two types of denial letters: Complete or partial. A complete denial letter means your insurance company is not going to compensate you for any of the value of your financial losses. For example, if your vehicle sustained $5,000 worth of damage, your insurance company pays you nothing because the claim adjuster decided to deny the entire auto insurance claim.

A partial denial for a car insurance claim means your insurer pays for a percentage of your financial losses. For the $5,000 worth of damage to your car, your insurer might decide to cover just half of the $5,000. For example, a car accident might have cost you $2,500 to repair the damage done to the stereo system and another $2,500 worth of damage done to the suspension. Your policy might include language that allows your insurer to pay for necessary repairs such as the damage done to the suspension system, but not the damage done to optional accessories like a car stereo.

You have the right to appeal both a complete and a partial insurance claim denial decision.

Filing an auto insurance claim in Fort Myers, Florida seems like a straightforward process. Your vehicle received damage because of an accident and you sustained an injury that requires completing a treatment program. You file a car insurance claim to recover the financial losses that are associated with medical bills and the cost of repairing your vehicle.

However, your car insurance company might deny your claim, which can be either a partial or complete denial of your claim. You should learn why auto insurance companies deny claims before you file your claim for financial assistance.

Coverage Limit

Before you file a car insurance claim, you must review your policy to determine coverage limits. Your insurer denies claims that do not have enough coverage. For example, if your car is worth $50,000 and it is totaled because of an auto collision, your policy does not cover the entire amount of $50,000 if your policy contains a property damage coverage limit of $25,000.

The most likely outcome of an insurance claim that exceeds a coverage limit is your insurance company covers the value of the policy up to the designated limit. In our example, this means you should receive a check for $25,000 to cover the costs that are associated with repairing your vehicle. Nonetheless, some unethical insurance adjusters deny entire claims even if the policy contains language that pays for coverage up to the designated policy limit.

Working with an experienced personal injury attorney can help you fight back against unethical insurance adjusters.

Expired Coverage

The most obvious reason for receiving a denied insurance claim decision in Fort Myers is your policy expired before the auto accident. An expired policy can happen naturally, as the end date has passed for coverage. However, a current policy can expire if you fail to keep up with premium payments. Your insurance company can make your policy null and void if you failed to meet the claim filing deadline. This means you should file an auto insurance claim as quickly as possible after a car accident. Working with one of our highly-rated personal injury lawyers helps you act with a sense of urgency when it comes to filing a car insurance claim.

Driver Not Listed on Car Insurance Policy

If the driver who is legally liable for causing a car accident is not listed on the car owner’s auto insurance policy, the insurer has the right to deny the entire claim. This is often the case when a teenager who has a learner’s permit drives the parents’ vehicle and causes an accident. It also can happen when a friend or a relative borrows a vehicle and gets into an auto collision. Make sure everyone who is authorized to drive your car is listed on your insurance policy.

Business Trips

Another reason for a denied claim is when a policyholder uses an insured vehicle for a business trip, but the car insurance policy does not provide coverage for an accident that occurred during the business trip. If you do not notify your insurer about your use of an insured motor vehicle during a business trip, your insurance company might deny a claim that is filed for a car accident that unfolded during a business trip.

Accident With an Uninsured Driver in Fort Myers

Although most states require liability insurance, several states do not require coverage for an accident with an uninsured driver. Florida is one of the few states that does not require residents to purchase coverage for an accident with an uninsured motorist. If you get into a car accident with an uninsured driver in Fort Myers and you do not have uninsured motorist coverage, you can expect your insurance company to deny your claim for compensation.

Bad Faith

If an insurance adjuster made a claim decision in bad faith that denies a request for financial assistance, you should contact one of our car accident attorneys to appeal the insurance claim decision. A bad faith claim denial frequently happens because an insurance adjuster ignored the physical evidence submitted by the policyholder. Another common cause of a bad faith decision is an insurance adjuster needs a little more information to approve your claim, but refuses to tell the policyholder to submit the additional information.

How you respond to a negative insurance claim decision determines the success of an appeal for a denied claim. You have the right to know why your insurance company denied your claim, as well as the steps your insurance company wants you to take when you file an appeal. When you file an insurance claim, you assume the legal burden of proving that you deserve to have your claim approved. For a denied insurance claim decision, your insurance company assumes the legal burden of proving why the insurance adjuster denied your claim.

If you feel your insurance company made an error by denying your claim, you should learn how to file a more persuasive appeal to cover your financial losses.

Work With an Experienced Auto Accident Attorney

If you did not hire a car accident lawyer when you file the original insurance claim, you should work with an experienced litigator to submit the most compelling appeal for compensation. One of the highly-rated car accident attorneys from Morgan & Morgan devises a strategy for submitting your appeal. Working with an experienced personal injury lawyer might help you build a positive professional relationship with the insurance adjuster investigating your claim.

Submit More Convincing Evidence

The key to overturning a denied insurance claim decision involves submitting more convincing evidence with your appeal letter. Your personal injury attorney plays an especially important role in gathering and organizing evidence. Perhaps you did not demonstrate your vehicle sustained property damage at the value you listed within your insurance claim. Maybe you did not submit enough documentation to prove you sustained one or more injuries. Most insurance adjusters that deny claims want to see additional evidence before approving a claim.

Recruit Witnesses

Right after the auto collision, you should have written down the names and contact information for every witness. Witness accounts of the car accident can support the evidence you submit with your appeal. Your legal counsel should interview each witness, and then choose the ones that provide the greatest legal support for your appeal.

Submit the Appeal Letter

This step is reason enough to hire an experienced car accident lawyer to represent you during the appeal process. The appeal letter must clearly describe why you disagree with the insurance company’s decision to deny your claim for financial assistance. Your legal counsel explains in detail why each piece of evidence matters when it comes to approving your claim. Emphasizing the submission of additional persuasive information, as well as including more witness accounts of the car accident, can help you gain approval for a denied insurance claim.

There is too much on the line for you to rely on an inexperienced auto accident attorney to represent you during the appeal process. Working with one of the skilled litigators at Morgan & Morgan can help you turn the disappointment of a claim denial into a favorable insurance claim decision. Morgan & Morgan has a strong presence throughout Florida, including the popular tourist destination of Fort Myers.

Schedule a free case evaluation to file the most effective insurance claim appeal.