Posted on Saturday, March 22nd, 2025 at 9:00 am
Were you recently hurt in an injury accident? Are you getting the run-around from an insurance company? If so, you’re sadly not alone. Learn why you should dispute an insurance claim below.
We buy insurance to protect ourselves from the unexpected, and we have a reasonable expectation that insurance will be there when we need it. Insurance companies certainly advertise themselves with this promise. However, the unfortunate reality is that insurance companies are big businesses, and shareholders invest in them with the expectation of big profits. Insurers know that if they pay out too many claims, they’ll quickly find themselves with angry investors. Their solution? Do play hardball with accident victims by denying claims, pushing them to accept paltry settlements, and slow-walking the process to wear them down.
Fortunately, there’s something you can do to fight back and assert your rights: involve an attorney in your insurance dispute.
Common Reasons for Insurance Claim Disputes
Insurance companies dispute claims in an attempt to save themselves money. Too often, they’re an attempt to wear down a claimant to the point that they give up. Here are some common scenarios that might lead you into a dispute with an insurance company:
Disagreement Over Liability – The insurance company may argue that you were partially or fully at fault for the accident, reducing or denying your claim based on comparative negligence laws.
Insufficient Medical Evidence – If you don’t provide detailed medical records linking your injuries directly to the accident, the insurer may claim they are unrelated or exaggerated.
Pre-Existing Conditions – The insurer might argue that your injuries existed before the accident and were not caused by it, using prior medical history to dispute your claim.
Delays in Medical Treatment – If you wait too long to seek medical attention, the insurance company may assert that your injuries weren’t serious or weren’t caused by the accident.
Lowball Settlement Offers – Insurers often undervalue claims, offering settlements that don’t fully cover medical expenses, lost wages, or pain and suffering.
Disputed Medical Necessity – The insurance company may question whether all your treatments were necessary, denying coverage for certain procedures or ongoing care.
Policy Exclusions or Limitations – Your claim may be denied if the insurer determines that your accident or injuries fall under an exclusion in your policy.
Gaps in Documentation – If there are missing police reports, witness statements, or medical records, the insurer may use this lack of evidence to challenge your claim.
Missed Deadlines – Filing your claim too late or missing deadlines for submitting evidence can lead to a denial based on policy requirements.
Allegations of Fraud – If the insurer suspects any exaggeration, misrepresentation, or false statements, they may deny the claim outright and even investigate you for fraud.
Steps to Dispute an Insurance Claim
Now that you know why the insurance company might be disputing your claim, it’s time to learn how to challenge their position. Here are some practical steps you can take to resolve the dispute:
Review the Insurance Policy – Carefully read the policy in question to understand coverage, exclusions, and claim limits. This helps you determine if the denial or dispute is justified.
Request a Written Explanation – Ask the insurance company for a formal, written explanation of why your claim was denied or underpaid. This will clarify their reasoning and help you craft your response.
Gather Supporting Evidence – Collect medical records, accident reports, witness statements, photos, and any other documents that support your claim and contradict the insurer’s reasons for the denial.
Consult Your Medical Providers – If your claim is being disputed due to medical necessity or pre-existing conditions, ask your doctors to provide detailed statements explaining how the accident caused your injuries.
Write a Demand Letter – Draft a formal letter disputing the denial, outlining why your claim is valid, and providing supporting evidence. Include the amount you are seeking and a deadline for the insurer to respond.
File a Complaint with the State Insurance Department – If negotiations fail, you can report the insurer’s handling of your claim to your state’s insurance regulatory agency for further review.
Consider Mediation or Arbitration – Some policies require disputes to be resolved through mediation or arbitration before taking legal action. Check your policy and explore these options if necessary.
With all that said, perhaps the most important thing you can do is get legal help on your own. If the insurer refuses to settle fairly, an attorney can step on your behalf. They can negotiate, escalate the dispute, or file a lawsuit on your behalf.
When to Involve an Attorney in Insurance Disputes
The best time to involve an attorney in your insurance dispute is as soon as the insurer denies your claim or attempts to lowball your settlement offer. Early intervention means your lawyer has more options to pursue and can better assert your rights.
Is an insurance company disputing your claim and leaving you high and dry after an accident? If so, the team at London Harker Injury Law wants to hear from you. We have dedicated ourselves to helping accident victims in Utah get the money they need to rebuild their lives. We can do whatever it takes to demand justice on your behalf. We’ll do this by:
Independently investigating what happened and identifying all applicable insurance policies
Filing claims on your behalf and interacting with the insurance companies so you don’t have to
Gathering supporting documentation to bolster your claim and undermine the insurer’s position
Preparing your case for trial to bolster our bargaining position and anticipate the need to go to court to assert your rights
Negotiating aggressively for a settlement that reflects the fair and full value of your claim
Going to court if the insurer continues to dispute their liability for what happened
We will do all this at no upfront cost to you; instead, we will charge a fee only if we win your case. That way, you can assert your rights without worrying about your bank account.
Don’t wait another moment to assert your rights to fair compensation. Contact our law firm today at (772) 272-7274 or through our online form for a free consultation with a Utah personal injury lawyer.
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