After an accident, you expect your insurance claim to help cover your medical bills, lost wages, and other damages. Unfortunately, insurance companies are notorious for denying or delaying valid claims. Their goal is often to minimize payouts—not to ensure you receive the support you need.
At Hillstone Law, we help clients across California fight back when insurance companies refuse to pay. Understanding the common reasons for claim denials can give you an advantage when pursuing the compensation you deserve.
Why Do Insurance Companies Deny Personal Injury Claims?
Insurance carriers often rely on strict procedures, paperwork requirements, and technicalities to reduce or deny claims. For example, they may:
- Impose strict deadlines for submitting documents
- Require specific forms or formats for evidence
- Dispute liability even when fault seems clear
- Minimize or deny the extent of your injuries
Even minor mistakes or missing documentation can give the insurer a reason to deny coverage.
The 3 Most Common Reasons for Claim Denials
1. Denial of Liability
Liability is the cornerstone of most personal injury claims. If the at-fault driver or party is identified, their insurance carrier should be responsible for compensating you. However, insurers often argue:
- The driver was not at fault
- The victim was partially responsible for the accident
- The insured was only minimally liable, reducing the payout
By shifting blame, insurers can reduce how much they are required to pay—or avoid payment altogether.
2. Denial of Injury
Not all injuries are easy to prove. Conditions like whiplash, spinal injuries, traumatic brain injuries, or internal damage may not show up immediately. Insurance companies often use this as an excuse to claim:
- The injuries were not caused by the accident
- The injuries are less severe than reported
- The victim is exaggerating symptoms
Insurers may even hire their own doctors to downplay your injuries. Having your own independent medical evaluation can be critical in these cases.
3. Disputing Causation
Even when injuries are documented, insurers may argue they were the result of a pre-existing condition rather than the accident. They often point to prior medical records to claim:
- The injuries existed before the accident
- The crash merely “aggravated” an old issue
- Treatment was unrelated to the incident
To counter this, expert medical testimony and thorough documentation are often needed to prove the accident directly caused or worsened the injury.
How a Personal Injury Attorney Can Help
Facing an insurance denial on your own can feel overwhelming—but you don’t have to handle it alone. At Hillstone Law, our attorneys will:
- Review your insurance policy and the denial letter
- Gather and present evidence proving your injuries and damages
- Work with medical experts to establish causation and severity
- Negotiate with the insurance company for a fair settlement
- Take your case to court if the insurer refuses to pay
Our goal is to ensure you receive the compensation you need for medical bills, lost income, pain and suffering, and other accident-related damages.
Contact Hillstone Law Today
If your personal injury claim has been denied or undervalued, don’t let the insurance company have the final say. Contact Hillstone Law today for a free consultation. Our experienced team will fight to hold insurers accountable and secure the compensation you deserve.