What to Do When Your Insurance Claim is Denied

A bad situation just got worse. You were driving your car home from work and were involved in an accident in downtown Portland. You had to go to the doctor a day or two later, because you were injured. It meant you missed a couple of days off work; you weren’t paid, and your boss is still not happy.

And now you get a letter from the insurance company saying, “Sorry, but your claim has been denied,” along with a jumbled explanation dripping with legal jargon and quotes from clauses in your policy you’ve never read. What to do? The first thing to consider is contacting an Oregon insurance lawyer. And don’t panic.

Insurance companies have a vested interest in denying claims. This doesn’t mean they’re dishonest, but an Oregon insurance lawyer will tell you, insurance companies only have to find a small area of doubt in your claim to issue a denial. 

This is a starting point, however, and it’s important not to give in too easily, as many people do. If you have an Oregon insurance lawyer fighting your case, the insurance company will probably become far more reasonable, and far more quickly.

Why deny my Portland injury claim in the first place?

It doesn’t take much for an insurance company to deny a claim, but the most common reasons for a claim denial include:

  • You have the wrong kind of coverage on your car for the claim presented. If you have liability only and no collision coverage, your claim could be denied.
  • You made an uninsured motorist claim, but the other party was actually insured.
  • You’re not a named driver on the policy. This applies mostly to teenagers driving their parents’ cars, or to friends driving other friends’ cars.
  • You didn’t pay your premium on time. If the grace period has expired by even five minutes, insurance companies will use this as an “out.”
  • The amount of your claim exceeds your policy limits. In this case, the insurance company will normally refuse to cover the excess, but the entire claim could be denied.
  • You bought a new/different car and failed to let the insurance company know within the specified time.

How do I contest their decision? Do I need an insurance attorney?

Immediately write to the insurance company and explain to them why you think your claim is valid, and why their reasons are not. Send as much documentation as you can find to support your claim. If you are dealing with a reputable insurance company, they will hopefully make you a fair settlement offer. If a respected Oregon insurance lawyer takes your case, they can write this letter for you, and make sure the insurance company follows up on any policy agreements.

If you still don’t receive a satisfactory response, other avenues are open to you. Again, you may decide to act on your own, or have an experienced Oregon insurance lawyer do it for you. You may elect to:

  • Appeal the insurance company’s decision to the Oregon State Insurance Commissioner.
  • Fight fire with fire. File a bad faith lawsuit against the insurance company; hold them accountable for breach of conduct and possible violations of Oregon State insurance codes. If you decide to file a suit, you will definitely need the help of a good Oregon insurance lawyer.
  • File a suit against the responsible driver. If someone else caused the accident, and their insurance company is delaying your settlement, it’s not the same as denying your claim. Once again, a good Oregon insurance lawyer will expedite the process and either negotiate a settlement on your behalf or lodge a suit against the other driver.

Having your insurance claim denied can be a frustrating, annoying experience. Insurance companies are required by Oregon law to act in good faith, and failure to do so could leave them open to multiple charges, negative publicity and large costs. If you feel your claim is fair and just, do not be afraid to either tackle the insurance company yourself, or to hire an Oregon insurance lawyer to do it for you. Don’t give up after you’ve received one letter denying your claim. Know your rights, and fight for them.