How To Proceed If Coverage Has Been Denied?

Someone that has filed a personal injury claim against the insurance company of the party responsible for a given accident does not have to abandon hope for receiving any compensation, if the requested coverage has been denied. Instead, the denied man or woman should work with a lawyer, in order to learn why the coverage was denied.

Possible reasons for a denial of coverage:

• The other party has allowed the policy to lapse.
• The location of the accident falls outside of the boundaries specified in the policy.
• The person held responsible for the accident is not covered by the other party’s policy. That could be the case of a car owner allowed someone without a license to drive the insured vehicle.
• The accident took place in a state or province with no fault vehicle insurance. Consequently, the victim cannot make a 3rd party claim.

Why the denial does not put an end to the negotiating process?

There are no rules with respect to what can and cannot be discussed during that process. Hence, the lawyer can fight the denial while continuing to negotiate with the insurance company.

Steps to take as the process moves forward:

Ask for a written statement that provides useful details on the exact reason for the denial of coverage. If the denial came from the other party’s insurance company, ask to see the other party’s policy. If necessary, ask just for the sections that relate to the denial.

Do not be surprised to hear from a Personal Injury Lawyer in Ottawa that works for the insurance company. Understand that the lawyer’s opinion cannot serve as legal grounds for a denial. Only a court has legal grounds for declaring the insurance company’s right to deny coverage.

Keep communicating with the insurance company, unless some document presented by them proves their case. Do that with the following understanding in mind, but not with the thought of ending the attempt to win a fair compensation.

Understand that the claim made by the victim of a personal injury accident does not get silenced just because one insurance company has refused to cover that claim. There are usually any number of different people at an accident scene. A lawyer might be able to prove that one of them helped to trigger occurrence of the injury-causing accident.

A lawyer can speak with witnesses and view any video footage from cameras in the area. That might aid discovery of a previously unseen action by someone else at the accident scene. Perhaps that same person could be held responsible for what happened that day. A lawyer would also make sure that all the traffic signs were in place, and all the traffic signals were functioning as expected, on the day when the involved vehicles collided.