The pain and inconvenience of a car accident may be just beginning as emergency responders treat you on the scene or transport you to a New Jersey hospital. Depending on the severity of your injuries, you may be looking at thousands of dollars in medical bills, lost wages and serious financial struggles. Since New Jersey is a no-fault insurance state, you file a claim with your own insurer.
Just when you think things can't get worse, you learn that the insurance company has denied your claim for benefits. Perhaps this doesn't make sense to you. You are legitimately injured, and you purchased insurance for such situations. However, there are circumstances for which your insurer may rightfully deny your claim.
The details of your policy
The first thing you will want to do after receiving a claim denial is to carefully review your policy. Have you missed a payment or paid too late to avoid the cancellation of your coverage? If your payments are up-to-date, read the terms of your policy. These explain the limits of the coverage for which you paid.
It is possible that, if you purchased a policy at a bargain price, it actually provides very little coverage. Each state has its minimum requirements for car insurance, but the minimum is usually far from what you need if you suffer serious injuries. Understanding the coverage you have paid for is an important thing to do long before you are involved in an accident.
Other reasons for coverage denial
If your policy is in good standing and you have adequate coverage, there are still reasons why the insurer may reject your request for payment; for example:
- Intoxication or otherwise acting negligently at the time of the accident.
- The accident occurred while you were using your car for business, and you do not have a commercial policy.
- You delayed after the accident before filing a claim, which may make the insurer suspicious of your injuries.
- You failed to follow up with the insurer or cooperate with the insurance company's investigation.
- You committed fraud by lying about the seriousness of your injuries.
None of these apply to you? Then it is possible that the insurer has denied your claim without a valid reason. You have options to appeal this denial, but you will have to work quickly since there are deadlines for taking this step. In fact, while you focus on your recovery, you may benefit from having an experienced legal professional handle any further communication with the insurer.