If you sustain injuries because of an accident due to negligence, the responsible party must pay for your losses, which include medical expenses, lost wages, and pain and suffering. To get the compensation you deserve, you can pursue a personal injury lawsuit or reach an out-of-court settlement with the defendant or their insurer. However, insurance companies will look for reasons to deny even valid claims and avoid paying compensation. That is why injured victims need a skilled personal injury attorney from njpa-law.com who can help them fight for their right to compensation. The following are common reasons insurance providers deny personal injury claims:
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Previous Injuries or Surgeries
Often, insurance companies ask victims to sign a medical release form, which authorizes them to get their entire medical history and find information about previous injuries or surgeries. If an insurer discovers any previous injury or procedure, it may claim that it caused the victim’s current injury. Also, the company can use any previous injury or surgery to reduce the severity of a claim.
Lack of Coverage
The person responsible for a victim’s injuries or accident must have an insurance policy that has enough coverage to cover claims for damages. Otherwise, an insurer can deny the claim. Let us say a victim sustained injuries in a slip-and-fall accident that happened at a retail store. If the store does not have enough insurance coverage to cover the damages of the victim, the insurance company of the store can deny the victim’s claim.
Injury Disputes
Insurance providers may dispute the extent of a claimant’s injuries. In this case, it will be argued that the kind of injury can’t be due to the accident. For instance, if the victim sustains low back injuries in a motorcycle crash, the insurance company can argue that the injury’s extent can’t result from this accident. This makes it important for claimants to have sufficient evidence that links their injuries to the accident. Evidence includes medical evaluations and reports, injury photos, eyewitness statements, expert witness testimony, and accident scene photos.
Delayed Filing
New Jersey has a deadline for submitting personal injury claims, just as many other states. These restrictions have been put in place to protect the integrity of the accessible data and to back up the veracity of the assertion. Claimants have two years from the accident or injury date to file an injury claim. Failure to file within this timeframe can result in the denial of the claim.
Insufficient Evidence
Insurance companies frequently reject claims because the proof is insufficient or poor. The insurance company may contest the claim if the claimant’s evidence is insufficient to establish both the amount of the injuries and the at-fault party’s negligence. Lack of medical records, the absence of reliable eyewitness reports, or ambiguous accident site images are examples of insufficient evidence. In order to support their claims, claimants must immediately begin gathering as much evidence as they can.
Disputed Liability
Sometimes, insurance companies dispute the liability of their policyholder, arguing that their client is not entirely at fault for the accident. In situations where there is shared liability, meaning both parties involved share some degree of fault, the insurance company might use this as a reason to deny or reduce the compensation. If the claimant is determined to be partially at blame for the accident under New Jersey’s modified comparative negligence rule, their compensation will be reduced by the proportion of their culpability. A claimant may not receive any compensation at all if they are deemed to be more than 50% at fault.
Neglecting to Reduce Damages
If the party who caused the accident doesn’t take the proper steps to lessen its effects, the insurance company has the right to reject a claim. The insurance provider can contend that a claimant failed to take reasonable precautions to reduce their damages if, for instance, they delay receiving medical attention too long after a car accident, exacerbating their injuries. The assertion can therefore be wholly or partially disproved.
Policy Exclusions
Exclusions in insurance policies that outline the kinds of accidents and injuries they exclude are frequently included. The insurance provider may reject the claim if the reason for the accident or the type of injuries falls under these limitations. To properly grasp the extent of coverage, claimants must carefully read the terms and conditions of the applicable insurance policy.
In summary, successfully handling a personal injury claim in New Jersey demands a thorough grasp of the state’s intricate legal framework. It also necessitates the capability to collect substantial evidence and construct a compelling case. Engaging an experienced personal injury attorney familiar with New Jersey’s laws can greatly enhance the likelihood of a favorable outcome. This ensures that victims obtain the rightful compensation for their injuries and losses.
