Denial: Claims, policies and coverage concerns

Denial: Claims, policies and coverage concerns

July 09, 2021

Paying for auto insurance carries an expectation that your policy will be honored, claims will be accepted, and coverage will be continuous. Unfortunately, there are some scenarios where insurance companies can deny your expectations. 

There are several reasons why claims could potentially be denied. The first is policy limits. No matter the damage, every policy has limits. Once your claims exceed your coverage limits, the insuring company can deny additional claims. This can be mitigated by carefully considering coverage limits when you first apply for insurance so that you are less likely to exhaust coverage limits.

Insurance companies also deny claims due to violations of the law. If you submit a claim on an accident that occurred when you were driving without a license, driving drunk, or got into an accident that was avoidable, the insurance company may deny your claim.

Several other factors could cause an insurance company to deny coverage. A few of them include failing to report an accident to the police and/or your insurance company immediately; refusal to seek medical attention after an accident while later filing claims for injuries sustained in the accident; misrepresenting information when you request a quote; and obtaining insurance with a company that isn’t licensed to operate in the state you live in.

Claim, policy and coverage disputes can sometimes be settled by filing an official complaint. Most states have complaint departments and mediation programs to help negotiate agreements between individuals and insurance companies. Before you call a lawyer, find out if your state has a system set up for claim denial complaints. If that option isn’t available, contacting an attorney may be the next best step.

Claims adjusters are quick to point out that drivers can protect themselves by following a set of guidelines. First, file claims with your insurer directly rather than making third party claims, which are more commonly denied. If you’ve been in an accident with another driver and you are not liable, the other driver’s insurance might not want to cover your claim in a timely fashion, so it’s best to go straight to your own insurance company first.

While accidents can be incredibly stressful and painful, do your best to remain friendly and cooperative when working with the adjuster. A busy claims adjuster usually has a few hundred claims going at the same time, so they may be more pleasant and helpful to customers who are easier to work with. Your kindness and cooperation might help gain some points with a busy adjuster, resulting in them processing your claim faster.

It’s also good to provide as much information to the adjuster as possible. Collect information on the accident and make sure you don’t leave any details out. The process goes much faster when complete and comprehensive information is available to the adjuster without having to go back and forth between several parties.

When you’re ready to switch your homeowner’s insurance, give us a call! We’ve been helping clients save money and protect their homes for decades. Our team can make the insuring process smooth and painless so that you can live worry-free. To reach us by phone, call (715) 754-5254 or (920) 822-3695. You can also email us at or visit to learn more.