After an accident, discovering that your insurance claim has been denied can make an already stressful situation even harder. When another person’s negligence causes injury or property damage, you deserve compensation. Unfortunately, insurance companies sometimes reject valid claims. Understanding why denials occur and what you can do next can make all the difference.

Common Reasons Insurance Claims Are Denied

Insurance companies may reject claims for a variety of reasons. Being aware of the most frequent causes helps you prepare a stronger case.

Bad faith behavior
Insurers are legally obligated to investigate legitimate claims fairly and to fulfill their contractual duties. If an insurer delays without cause, misrepresents policy terms, or refuses to pay without justification, this may be considered acting in bad faith.

Missed deadlines
Most policies require that claims be reported promptly after an incident. In California, you generally have two years from the accident date to file a personal injury lawsuit. Missing these deadlines can result in an automatic denial.

Lapsed or insufficient coverage
If your policy was inactive due to missed payments or cancellation, or if the type of loss is not covered under your policy, the insurer can deny the claim.

Excluded damages
Certain losses, such as specific accident types or non-collision damages, may not be included in your policy’s coverage.

Disputes over fault or liability
Insurers sometimes deny claims by arguing that you were at fault, that another party is responsible, or that the facts remain unclear.

Steps to Strengthen Your Claim

Reading your policy carefully ensures you understand your coverage limits, exclusions, and reporting requirements. Collect detailed evidence, including photos of the accident, medical records, police reports, and witness statements. Keep records of all communications with your insurer. Present a clear demand letter that outlines what happened, who is responsible, your damages, and your requested compensation, supported by documentation. Consulting a lawyer early can prevent mistakes and improve negotiations.

What to Do After a Denial

If your claim has already been denied, you still have options. Submit a written appeal through the insurer’s internal review process with any additional evidence. You can also contact the California Department of Insurance for guidance and oversight. When necessary, you may pursue legal action for personal injury or bad faith practices.

How Hillstone Law Can Help

Hillstone Law can review your denial letter and policy, help gather and present evidence, negotiate with your insurer, and file a lawsuit if needed. Our goal is to secure the full compensation you deserve.

Take the Next Step

An unfair denial does not have to be the final word. Contact Hillstone Law for a free case evaluation and explore your options for moving forward.