Dealing with a denied personal injury insurance claim can be frustrating and overwhelming. If you have suffered a personal injury and have been denied an insurance claim, you may feel hopeless and unsure about how to proceed. However, there are steps that you can take to handle a denied insurance claim for a personal injury in Boston.

Understanding Why Your Claim Was Denied

The first step in handling a denied insurance claim is to understand why your claim was denied. There could be several reasons why an insurance company denies a claim, including:

  • Lack of Evidence: If there is insufficient evidence to support your claim, the insurance company may deny it. This is why it is important to document everything related to your injury, including medical records, police reports, witness statements, and photographs.
  • Policy Exclusions: Your insurance policy may have exclusions for certain types of injuries or accidents. For example, if you were injured while participating in a dangerous activity, your insurance policy may not cover your injuries.
  • Failure to File in Time: Insurance companies have deadlines for filing claims. If you miss the deadline, your claim may be denied.
  • Pre-Existing Conditions: If you had a pre-existing condition that contributed to your injury, the insurance company may use this as a reason to deny your claim.
  • Dispute Over Liability: If there is a dispute over who is at fault for the accident, the insurance company may deny your claim.

Appealing the Denied Insurance Claim

If your insurance claim has been denied, you have the right to appeal the decision. The appeals process varies depending on the insurance company and the state in which you live. In Boston, the Massachusetts Division of Insurance oversees insurance companies and their practices.

  • Review Your Insurance Policy: Before appealing the decision, review your insurance policy to understand the reasons for the denial. If you have any questions, contact your insurance company or an experienced personal injury attorney.
  • Gather Evidence: If you believe that the insurance company made a mistake in denying your claim, gather additional evidence to support your case. This could include witness statements, medical records, and photographs.
  • Contact Your Insurance Company: Contact your insurance company and ask for a written explanation of the denial. You can also ask for a copy of your insurance policy.
  • File an Appeal: If you believe that your claim was wrongly denied, file an appeal with your insurance company. Be sure to include any additional evidence that supports your case.
  • Hire an Attorney: If you are having difficulty appealing the decision on your own, consider hiring an experienced personal injury lawyer in Boston. An attorney can help you navigate the appeals process and fight for your rights.

Filing a Complaint with the Massachusetts Division of Insurance

If you have exhausted all avenues of appeal and are still dissatisfied with the insurance company's decision, you can file a complaint with the Massachusetts Division of Insurance. The Division of Insurance will investigate your complaint and determine whether the insurance company acted appropriately.

  • Gather Documentation: Gather all of the documentation related to your claim, including medical records, police reports, and witness statements.
  • File a Complaint: File a complaint with the Massachusetts Division of Insurance. You can file a complaint online, by mail, or in person.
  • Provide Evidence: Provide the Division of Insurance with all of the evidence related to your claim, including any additional evidence that you have gathered.
  • Wait for a Decision: The Division of Insurance will investigate your complaint and make a decision. If the Division of Insurance finds that the insurance company acted improperly, it may order the company to pay your claim.
  • Hire an Attorney: If you are having difficulty navigating the complaint process, consider hiring an experienced personal injury attorney. An attorney can help you gather evidence and fight for your rights.

The Bottom Line

Handling a denied insurance claim for personal injury can be difficult, but it is important to remember that you have options. By understanding why your claim was denied, appealing the decision, and filing a complaint with the Massachusetts Division of Insurance, you can fight for the compensation you deserve.

It is important to document everything related to your injury, including medical records, police reports, witness statements, and photographs. This evidence can help support your claim and increase your chances of success during the appeals process.

If you are having difficulty appealing the decision on your own, consider hiring an experienced personal injury attorney. An attorney can help you navigate the appeals process and fight for your rights.

If you have any questions, contact an experienced personal injury attorney today.

Author's Bio: 

Master Coach Hu Dalconzo is an author, spiritual teacher and the founding father of the first spiritual life coaching healing modality, the HuMethod.™ His work stands shoulder to shoulder with other paradigm-shifting human potential movement greats such as Oprah Winfrey, Eckhart Tolle, Pema Chödrön, Wayne Dyer, Deepak Chopra, Louise Hay, Marianne Williamson, and Ram Dass. In 1993, Coach Hu founded Holistic Learning Centers, North America’s oldest spiritual life coaching certification school.