Following an investigation, the insurance adjuster at the defendant’s insurance agency might not view the facts in the same way as the accident’s victim. Fortunately, there are lawyers that understand how to deal with a denial.
Possible reasons for denial
The adjuster might question the merit of a submitted claim. Had the complaints been exaggerated? Did the evidence support the allegations that had been made?
Some adjusters try playing for time. Each of them hopes that the claimant might change his or her mind, concerning plans to pursue a claim, and perhaps, to file a lawsuit. If the same adjuster has failed to carry out a thorough investigation, then the claimant could have grounds for a lawsuit, one that would target the insurance company.
Sometimes the defendant’s insurance policy excludes coverage for any damage that might be viewed as an “act of God.” That usually eliminates coverage for any claim that has resulted from the damage caused by a natural event. It might even become the basis for denial of compensation to a family that has submitted a wrongful death lawsuit.
Sometimes the defendant’s policy contains details on a timeline, and a deadline for filing a claim. If the victim has exceeded that deadline, then the adjuster would have grounds for denying the submitted claim. Personal Injury Lawyer in Oakville hesitate to agree to handle a claim if the claimant has failed to seek legal help until a few weeks before the stated deadline.
It could be that a defendant’s policy has stated that only events that have taken place within a given area are covered by that same policy. That might provide an adjuster with another reason for denying a submitted claim.
How a potential claimant should fight a denial:
The first step would involve consulting with several personal injury lawyers, and then hiring one of them. Obviously, the best attorney would be one that had handled and won a similar case for other clients.
If the lawyer’s efforts failed to achieve reversal of the denial, then the claimant might consider the wisdom behind pursuing a lawsuit. What would be the cost of such a lawsuit? How would that cost compare with the possible future cost of a prescribed treatment, or of an interruption to the victim’s lifestyle or future plans?
Insurers take a chance, if they decide to deny a claim that has come from a young victim. Although he or she might not have established a definite lifestyle, that same victim might have some grand plans. If his or her performance in school, or performance on the athletic field could suggest the believability of such plans, then a court might agree to grant an award to the previously denied claimant.