The insurance company denied my claim- what now?

If the insurance company denies your claim, you should not take that as a determination that you have no case. In fact, how do you know they're not just trying to get out of responsibility? What you need to remember is that insurance companies are experts in this field while you this may be the first time you have had a claim. Their job, is to save the insurance company money, plain and simple. Especially when you are dealing with the other person's insurance company after you have been injured. For example, in a car accident or if you fell on someone else's property.

WHAT YOU CAN DO

First, you can ask them to put in writing what their reason is for denying the claim. Under Pennsylvania insurance law (see for example Title 31 Pa. Code Section 145 and 146) the insurance company is required to provide what their basis is for their decision. They are supposed to respond to any letter or writing from you within 10 business days.

Second, you can consider providing them with additional documentation. You have to prove your claim with records. For example, medical records, wage loss records, receipts, photos. If so, you can send them a letter, fax or email requesting that they re-evaluate your claim.

If the insurance company insists on denying your claim, and you believe that you have a legitimate case, then you must consider filing a law suit. Often, insurance companies play a numbers game. Some companies that if deny claims on the belief that a certain percentage of people will simply give up and go away. Result: they save money. But, if you are one of us who won't just give up and go away that easily, then filing with the appropriate court is the next step. Filing a law suit can be a complicated process and one which you most likely will need an experienced lawyer. You must also correctly file the suit papers and serve the correct responsible parties. Often, cases are still settled after suit is filed with the case going to a trial. To get the case resolved, however, you must take the correct steps toward trial, such as requesting documents, serving "interrogatory" questions on the other party(ies), taking depositions and obtaining expert reports.

If you would like more information, feel free to contact us.

David Schreiber
Of Counsel
Law Offices of Thomas Wolpert, PC
PAinjurycase.com
(610) 792-3304
deschreiber@thomaswolpert.com