Why Do Insurance Companies Deny Legitimate Injury Claims

Why Do Insurance Companies Deny Legitimate Injury Claims

If you’re currently upset because your injury claim was denied, we may be able to help you. Lots of accident victims face this problem, and if you’ve asked yourself “why do insurance companies deny legitimate injury claims” this article aims to answer that question. See, most people sign up for insurance because they believe it protects them. Rightfully so, as that’s how insurance is sold to us. We get bombarded by insurance companies on a daily basis. Advertisements promising that “we’re in good hands” or that we can “save money by switching” are constantly flashed in front of our faces. On our social media feeds, television commercials, in the mail, it’s as if the whole world needs to ensure themselves. So then why do insurance companies constantly turn their backs on accident victims?

In this article, we are going to talk about the reasons why we believe insurance companies deny legitimate injury claims. As always, our website provides information and opinions. It does not provide legal advice. The Tijerina Legal Group published stories and topics of discussion to better communicate with clients and accident victims who are seeking information about their legal options. Remember, if you’ve been hurt in an accident, dial SEVEN. That’s (956) 777-7777, call us NOW and schedule a free injury consultation with award-winning McAllen Personal Injury Attorney Humberto Tijerina. Now, let’s dive deeper into why insurance companies deny claims.

The Top 10 Reasons Why Insurance Companies Deny Injury Claims 

Look, whether you got hurt in a car crash or a trucking accident, it doesn’t matter. Pain is pain, plain and simple. From slip and fall injuries to catastrophic accidents, when you’re hurt you need cash. Money isn’t the most important thing in the world, however, when you’re hurt you need support. We are NOT just talking about medical and hospital expenses. First off, if your injury is severe you may need physical therapy. The road to recovery can belong, and if you need months to years of rehabilitation treatments that can cost hundreds of thousands of dollars. Second, if you’re too hurt to work you may need assistance with lost wages.

The point is this, there are lots of things to think about when you’re facing an injury. The one thing you DON’T want to have to worry about is having your injury claim rejected. Insurance companies are not evil empires, they are not out to screw people over. Nevertheless, insurance firms are still financial organizations and if they can save a buck by denying your claim, they will. In our opinion, here are the top 10 reasons why insurance companies deny injury claims.

Lack of Medical Documentation 

Do you know why injury attorneys tell you “go to the doctor” after a crash or accident? While you want to believe that lawyers care about you (and we actually do) that isn’t the ONLY reason why we NEED you to go to the doctor. Insurance companies look for EVERY angle they can take to wiggle out of a claim. If you do not go to the doctor RIGHT after an accident an insurance company may try to use that against you. They may claim that if you were really hurt you would have gone straight away to the hospital. Even worse, if you don’t document your injuries via a third party like a doctor, and you cannot link them to the accident, the insurance company may be able to throw up a “smokescreen” claiming there’s no way to prove the accident caused the injuries.

Sounds crazy? It’s not, and it happens every day. Think about it. If you don’t seek medical attention right after the accident, and then “days later” something hurts or breaks, how would you be able to prove it was the accident that caused the injury. What if you slipped and fell when you came home, or if you got hurt playing with your kids? See our point, an insurance company knows how to find ways to mitigate their financial exposure. So do yourself a favor and if you are injured, seek medical attention right away.

They Believe the Claim is Fraudulent 

According to Insurance Information Institue, over 36% of insurance claims submitted are fraudulent. This means that insurance companies are on high alert whenever they receive injury claims. Insurance companies pay special underwriters and adjusters to review and analyze claims. If they believe a claim is illegitimate they may refer it to one of their attorneys to pursue legally. Compounding this problem is that insurance fraud costs taxpayers lots of money. In fact, the Coalition Against Insurance Fraud states that insurance fraud costs us over $80 billion dollars a year. This means that when you file your injury claim you have an uphill battle from the jump.

You’ve Been Hurt Before and Have Filed a Prior Injury Claim 

Insurance adjusters and underwriters look for patterns. It makes sense, it’s something we do daily in our field managing an injury law firm. If you’ve been injured before, and you’ve filed a claim in the past, you may be scrutinized heavily for additional claims. When you file a new injury claim an adjuster or underwriter might flag it. Think about it, if you were an underwriter and all you were given was a piece of paper stating that “John Smith” filed an auto accident injury claim a year ago and now is filing a new one, wouldn’t you be suspicious?

Now, if you are truly hurt, and you’ve just been the bearer of bad luck, you deserve financial compensation. However, it doesn’t mean the insurance company feels that way. To them, your case sticks out like a sore thumb and they want to make sure you’re not trying to defraud them out of money. We can help, that’s one thing injury attorneys actually do very well usually. That is, preparing a claim prior to submitting so that all of the “ducks are in a row” with your claim and evidence is provided to support your claim.

You Have Pre-Existing Injury Conditions 

Pre-existing injury conditions essentially means a syndrome or another accident caused an injury. While this new accident may have exasperated your current injuries, the crash or accident didn’t cause them. Now, insurance companies know that you are STILL entitled to support and compensation even if you have a pre-existing condition. Never the less, this is just another way insurance companies try to find loopholes to wiggle out of a financial jam, which means bailing on you when you need them most.

Injury Claims are Submitted Incorrectly

Believe it or not, this happens. There is a right way and a wrong way to file a personal injury claim. When injury claims are submitted incorrectly is once again gives an insurance firm a reason to deny your claim. Even when it’s a legitimate injury claim.

You Didn’t Submit Your Injury Claim in Time 

This also happens too often. Sometimes it’s the victim’s fault for being too lazy or unconcerned about getting paid after their injury. However, we believe this is very rare. What most likely happens is that an injury victim retains an attorney who makes a mistake or doesn’t know what they are doing. You have a limited amount of time to file an injury claim. If you miss that window you may be out of luck. Insurance companies know this, it’s one of the first things they check when they receive your claim.

Racism and Prejudice 

Even though we live in a technologically advanced world, it doesn’t mean that all people have advanced their thoughts and moral values. Racism and prejudice still exist, and you’d have to be ignorant or beyond sheltered to believe they cannot affect insurance decisions. In fact, the Chicago Tribune published an article back in May about a lawsuit filed against State Farm due to denied claims and racism. The Tijerina Legal Group has offices in McAllen and Brownsville. We service the entire Rio Grande Valley, and we know the type of prejudice and racial issues Latin-Americans face. Give us a call if you’ve been injured, even if you are here illegally, and we can help.

There Are Multiple Parties Involved in the Accident 

How often do you see car crashes that have three or more vehicles involved? All the time, and that’s a problem. In the legal world, we call these “chain reaction” car accidents. In the insurance world, they call them “get out of jail free” cards. See, when there are multiple cars involved determining whos at fault is beyond complicated. If you were hit by a car from behind and then pushed into a car in front of you, YOU may be legally at fault for the car you hit. Even though morally and ethically it wasn’t your fault. This is just another way insurance companies can try to deny legitimate claims.

You Filed a Personal Injury Claim Instead of a Workers Compensation Lawsuit 

While on the surface these type types of legal claims sound similar, they are not. Hiring an injury attorney who understands the difference is vital to the success of your claim. This article isn’t about the differences between personal injury and workers’ compensation claims. That topic requires it’s own blog, and a series of blogs if we want to truly tackle that issue. Never the less, too often inexperienced injury attorneys screw this one up.

The Insurance Company Doesn’t Want to Pay Your Injury Claim

And the number one reason why insurance companies deny claims, drum roll, please. The insurance company doesn’t want to pay your injury claim. We know, sounds asinine right? How can an insurance company just say “screw it, I don’t want to pay” and then stiff you with a fat injury bill? You have to remember that insurance companies are made up of PEOPLE. People are sometimes cranky, mean, in bad moods. People discriminate, get upset when others do well (like getting large amounts of money from an injury claim). The flat out, the number one reason in our opinion why legitimate injury claims get denied is simply because of human decision.

Why Do Insurance Companies Deny Legitimate Injury Claims and What Can You Do About It 

If you’re still wondering why do insurance companies deny legitimate injury claims and what can you do about it, call us. Our injury law firm loves to help clients, especially when claims are denied. You can reach us at (956) 777-7777 or you can click here to fill out our contact form 24 hours a day. In this article, we talked about why insurance companies deny claims, even when they are honest and legitimate. We also identified, in our opinion, the top 10 reasons why insurance companies deny injury claims. What we haven’t done yet is to provide you with a solution to your injury claim needs. So, what can you do after you’ve suffered an injury?

McAllen Personal Injury Attorney Humberto Tijerina 

Hi, I am Humberto Tijerina and I want you to know that I will personally FIGHT to protect your rights after an injury. Yes, I have a perfect 10 out of 10 AVVO rating. That’s correct, I am a TOP 100 Trial Lawyer in the entire nation. However, it’s not the award I won or the accolades I have accomplished that define me. Instead, it’s the cases I have settled and won for my clients. To me, treating my clients with respect, care, kindness, and professionalism is what makes me who I am. Injury victims have so many concerns, so much anxiety, and stress. My goal is to take that burden off of their shoulders, this way they can focus on recovering while my legal team and I fight for their financial rights.

Remember, if you’ve been injured DIAL SEVEN. Call me at (956) 777-7777 and I will personally speak with you about your injury case.