“My Insurance Company Is Denying My Accident Claims” What Should I Do?

Insurance companies deny thousands of Canadian accident claims each year. From 50.3% in 2020 to 64.8% in 2021, the percentage of claims refused due to insufficient coverage increased significantly. Good thing, you have options if your motorcycle accident claim is dismissed.

However, you must know what to do if your Canadian insurance provider denies your motorcycle accident claim. Today, we’ll discuss why Edmonton motorcycle claims are often refused, how to appeal, and how lawyers for motorcycle accidents can improve your odds of success. You can simplify insurance company dealings by knowing your rights and processes.

Why Accident Claim Denials Happen

Common Denial Reasons

  • Policy Exclusions. Certain exclusions in insurance policies can deny motorcycle accident claims. These may include motor vehicle accidents, injuries, high-risk activities, and policyholder fault.
  • Lack of Proof. Lack of evidence or paperwork is a common denial cause of personal injury claims. Insurance firms need witness statements and motorcycle accident case reports.
  • Late Accident Reporting. Your claim may be refused regardless of legitimacy if you fail to report the motorcycle accident within the prescribed timeframe.
  • Disparities in Accident Report. Inconsistencies in motorcycle accident report can deny your claim. Insurance companies will review the details, and any discrepancies may result in coverage denial.
  • Policy Limits and Coverage Issues. Insurance restrictions and coverage conditions apply. The company may refuse if your motorcycle accident claim exceeds these limits or is not covered. 

Identifying Poor Insurance Responses

Insurance ResponsesTechnical AnalysisTips to Handle
Refusal to Pay for Covered DamagesInsurers may motorcycle accident deny claims using ambiguous policy language or selective interpretation.Document all communications, cite specific policy clauses, and consider legal action or regulatory complaints.
Prolonged SettlementsDelays may indicate bad faith practices involving extended investigations or unnecessary information requests.Keep detailed logs of all interactions, file complaints with regulatory bodies, and present evidence of delays if pursuing legal action.
Ignoring Evidence and Excessive Documentation RequirementsInsurers may ignore valid evidence or demand excessive documentation to obstruct claims.Corroborate evidence with professional evaluations, use proper documentation, and explore formal dispute resolution or litigation.
Blaming the PolicyholderInsurers may shift blame to the policyholder, citing contributory negligence or policy violations to deny claims.Compare policy wording, gather evidence, and apply legal tactics to refute insurer claims with facts and experts.
Low Settlement OffersInitial offers are often undervalued and do not cover all costs.Assess claim worth, make a solid counteroffer, and consult a lawyer. If necessary, sue for fair recompense.

Real Life Motorcycle Accident Cases

#1: Insurance Company Denies Liability

Nino rode his motorcycle home from work in Enfield through a green signal. An auto driver ran a red light and hit him. Her insurer denied responsibility for the motorcycle crash because there were no witnesses, and the motorist claimed she had the green light.

Evidence and Investigation

  1. Security Camera Video: They examined security footage of Dickinson Road autos proceeding from a halt to the intersection. After 30 seconds, Nino entered the intersection and collided.
  2. Scene Investigation: The legal team thoroughly investigated the scenario to establish the traffic light cycle time. Nino’s direction light was green for 40 seconds.

Legal Strategy and Results

Personal injury lawyers proved Nino had the green light when the collision occurred with this proof. They also accused the insurance firm of bad faith and unjust settlements. After receiving notification of these allegations, the insurer assumed full duty and settled for $865,000

Key Legal Issues

  • Gathering Evidence. Detailed evidence collection and analysis (security camera footage and traffic signal timing) succeeded in the case.
  • Claims of Bad Faith. The lawyers used pressure by accusing the company of bad faith to change its attitude.
  • Settlement. The case emphasizes the need for comprehensive inquiry and strategic legal maneuvering for client success.

#2: Insurance Company’s Noncompliance

Paul was riding his motorcycle on a weekend in Litchfield, Connecticut, when a motorist made a left-hand turn and hit him. After the motorcycle accident, Paul cracked numerous ribs and needed medical treatment for the loss of use of his right hand.

Legal Issues

The at-fault driver’s insurance company initially avoided accountability and communication, which hindered Paul’s reimbursement of medical bills.

Legal Strategy and Results

Paul contacted lawyers after discovering the insurance company’s unwillingness to comply. They informed the adjuster immediately that they would seize the defendant’s land and assets if all insurance limitations were not met within two months of the accident.

Significant Legal Considerations

Strategic DeadlineThe firm required the insurance company to offer policy limitations within two months of the accident. This pressured the insurance to respond quickly to prevent legal action.
Threat of Asset AttachmentHis lawyers showed their willingness to take strong motorcycle accident claim to recover Paul’s injuries by threatening to attach the defendant’s property and land
Prompt Legal ActionFiling to attach property and land to the defendant within days of the two-month deadline showed the firm’s legal expertise and negotiation muscle

What to Do Following a Claim Denial

1. Reread the Deny Letter

After your insurer denies your accident claim, read the denial letter carefully. This paper explains the denial and cites policy clauses.

Look for these details:

  • Denial reason. Specify the claim denial grounds. This could be policy exclusions or insufficient evidence.
  • Policy Reference. Note any policy terms or sections the insurer cites for the denial.
  • Next Steps. Check for appeal procedures and deadlines for additional information or documentation.

2. Compare Your Policy

After you seek medical treatment, it’s important to understand the insurer’s reasoning and compare the refusal letter to your insurance coverage. This comparison will reveal discrepancies and misunderstandings.

Major Actions:

  1. Understanding your coverage and exclusions. Understand your policy’s coverage and exclusions by reading it carefully. Read the policy definitions and conditions carefully.
  2. Find discrepancies or misunderstandings. Compare denial grounds to policy comprehension. Check for insurer misinterpretations or misapplications of policy provisions.

3. Collect Required Records

Gather all supporting paperwork to appeal the denial. This includes any evidence that contradicts the denial justifications.

Essential Documents:

  • Accident Reports. Get all accident reports, including photos of the accident scene and workplace or police report. They present an authoritative account of the motorcycle accident.
  • Medical Records. Keep all records of your suffered injuries, treatments, prognoses, and medical bills.
  • Statements of Witnesses. Get motorcycle accident witnesses’ statements in writing. They might confirm your story that you’re really involved in a motorcycle accident.
  • Insurance Company Correspondence. Keep email, letter, and phone call logs of conversations with the insurance provider. This documentation can prove reporting compliance and establish a claim timeline.

Addressing Concerns with Your Insurance Provider

Reaching the Adjuster

Communication with the insurance adjuster must be clear and professional. Start with your purpose and claim number.

Effective Communication Tips

Even when frustrated, be polite and professional. State the goal of your call or email and include claim details. Prepare specific questions like:

  • Could you please elaborate on the grounds for the rejection?
  • Which policy provisions denied the claim?
  • What evidence can I offer to support my claim?
  • When an appeal has been filed, what happens next?

Asking for Legal Assistance: Talking to a Motorcycle Accident Lawyer

When To Consider Legal Advice

Legal representation protects your rights and successfully presents your position when dealing with large financial stakes or prospective court issues.

  • Complex Cases: If your claim involves serious injuries, losses, or legal issues, seek motorcycle accident lawyers.
  • Denial Disputes: If your insurer rejects your initial appeal, an accident lawyer in Edmonton can assist you in the litigation.
  • Unfair Practices: Lawyers in Edmonton can help you sue the insurance for bad faith—delaying, denying without cause, or proposing unfair settlements.

Legal Consultation: What to Anticipate

  1. Assessing Cases. Motorcycle accident lawyers will analyze your claim, refusal letter, and supporting papers.
  2. Legal Advice. You’ll learn about your case’s feasibility, legal strategy, and lawsuit steps with the help of Edmonton motorcycle accident lawyers.
  3. Next Steps. Motorcycle accident lawyers may suggest gathering more evidence, filing a complaint, or preparing for litigation.

Filing a Complaint

You can complain to the Financial Services Regulatory Authority of Ontario (FSRA) or the Insurance Council of British Columbia (ICBC) if your insurance provider mistreated your claim or you didn’t receive the maximum possible settlement. These regulators regulate insurance operations and enforce provincial regulations.

Procedure for Making a Complaint

  • Collect documents: Gather your policy, refusal letter, and insurer correspondence.
  • File Complaint: Most regulatory authorities have online complaint forms or processes. Carefully follow their instructions.
  • Investigation: The regulator may mediate or enforce your complaint after investigating the insurer’s activities.

 

motorcycle accident edmonton

 

Call A Personal Injury Lawyer After a Motor Vehicle Accident

Knowing your insurance plans and rights will help you get the coverage and reimbursement you deserve as a motorcycle accident victim. If you’re having trouble with an insurance claim, don’t hesitate to get some legal assistance. 

Ask a motorcycle accident lawyer for your personal injury claim. Sidhu Personal Injury Lawyers can help you navigate insurance claims and improve your chances of a good outcome on your motorcycle accident case.

Frequently Asked Questions

Provide more evidence or documents to support your claim to appeal your insurance company’s denial. Write your insurer a dispute letter. Consider this format:

Header:

  • Your Name
  • Your Address
  • Your Contact Information
  • Date

Recipient Information:

  • Insurance Company Name
  • Adjuster’s Name
  • Claim Number

Introduction:

  • State the purpose of your letter (i.e., to dispute the claim denial).

Body:

  • Claim Summary: Briefly describe the initial claims, including the date and nature.
  • Dispute Reason: Explain why the denial is wrong, citing policy words and offering a counterargument.
  • Supporting Proof: List and briefly summarize the supporting papers.

Conclusion:

  • Request a reevaluation of your claim and express your willingness to provide any additional information required.

The intricacy, responsiveness, and need for legal processes affect how long it takes to resolve an insurance claim dispute. Disputes may take 6 months to over a year to settle, while other situations can be settled swiftly within 2-3 months with an experienced motorcycle accident lawyer.

Motorcycle accident victims should take insurance company fraud accusations seriously and reply quickly. They should provide proof to refute the accusation and consult motorcycle accident lawyers. Anticipating fraud accusations is vital since they might have major implications.

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