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How to Appeal a Car Insurance Claim Decision in Cincinnati - lawyer signing papers with client

How to Appeal a Car Insurance Claim Decision in Cincinnati

Car Insurance Claim Lawyer in Cincinnati


Cincinnati, OH


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Car Insurance Claim Lawyer in Cincinnati

It's heartbreaking to find out that you won't receive any compensation for your injuries following a car accident in Cincinnati, Ohio. It's even more painful when you realize that you need medical treatment for your injuries but the insurance company won't write you a check to settle your medical expenses and other costs deriving from the accident. If that's what you're going through at the moment, you'll be glad to discover that all hope is not lost. Here's how to appeal a car insurance claim decision in Cincinnati. 

Before we even discuss the process of appealing the claim, let's first look at some of the most common reasons insurance companies deny such claims.

Why Car Insurance Companies Deny Claims

A car insurance company might deny or undervalue a claim for the following reasons: 

They Claim You Caused the Accident

When you're involved in a car accident and file a claim, the insurance company will contact you to find out more about the accident. If you suffered minor injuries and the insured is a fault, the insurance company will likely agree to settle.

This is because it's pointless to fight such a claim. When the costs of settling a claim are lower than the cost of fighting the claim, insurance companies will most likely agree to settle. 

But when the claim is higher than the legal costs involved, insurance companies might decide to dispute the claim or pay less than what you may be entitled to as compensation. 

After the accident, the insurer will send a claims adjuster to review the damages. Then, the adjuster will contact you to find out more about the accident. These individuals usually sound friendly. As a result, you might reveal more than you should or say things that could be used against you when you file a claim.

This is the number one reason car accident attorneys always advise their clients not to provide any recorded statements to claims adjusters. While an insurance claims adjuster's role is to evaluate the value of a claim, they'll always protect their employer's interests. Any statement you provide could be used against you. And when that happens, insurance companies may deny or undervalue your claim even if they know you deserve better compensation. 

They Doubt Your Injuries

Insurance providers might doubt your injuries for several reasons. First, they could claim that the injuries were not that serious. Some will even dispute your claims due to general assumptions. 

For example, some providers hire private investigators to monitor a plaintiff's activities. So if you post a picture on social media of you and your friends having fun at the beach days after the accident, the insurer could use such pictures to dispute the validity of your claim. But this could be a case of general assumption over facts because posting a photo on social media doesn't mean that you took it on that same day. 

To avoid such twists and turns that divert attention from the most important issues in a car accident claim, lawyers always advise their clients to be careful of what they post on social media after an accident.

Another reason the car insurance company might doubt your claim is if you had prior injuries before the car accident. For example, if you slipped and fell down a staircase years ago and broke your back, the insurer could claim that your recent injuries are more related to your slip and fall incident than the car accident. 

You Didn't Notify the Insurance Company in Time

It's always advisable to notify the insurance company about a claim as soon as possible. This is because when you delay, the insurance company could claim that the accident had nothing to do with your injuries. They'll even accuse you of committing insurance fraud. But there are many reasons it may not be practical to inform the insurance provider about the accident right away. In that case, an experienced car accident attorney can help. Generally, it's always advisable to report a car accident at least 72 hours after the accident. 

It's also important to note that reporting a car accident doesn't necessarily mean that you're filing a claim at that particular moment. It makes more sense to consult further before filing a claim in some cases. This is because when you file a claim prematurely, the insurance company won't be responsible for additional compensation if you need more treatment for your injuries. 

It's almost impossible to file a claim with an insurance provider if the statute of limitations for that particular claim has expired. The statute of limitations for filing car accident claims in Ohio is two years from the date of the accident. 

You Didn't Seek Medical Attention

Car accident attorneys always advise their clients to seek medical attention right after the accident. This decision comes with two main advantages. 

It lets you find out the nature and severity of your injuries. Some injuries might seem mild initially but lead to severe complications weeks or months later. For example, if you suffered internal injuries, the only way to find out is by visiting a doctor for x-rays. 

While the symptoms of internal injuries might seem quite similar to common symptoms you shouldn't be concerned about, the result could be life-threatening. Internal bleeding is a good example of injuries that are not easy to detect with the naked eye but have serious effects. When you bleed internally, blood clots will begin to form inside your blood vessels, preventing the flow of oxygen into your brain. As a result, you might suffer from permanent brain damage and other complications. 

The other reason for seeking immediate medical attention after a car accident is to establish the validity of your injuries. When you visit a doctor for diagnosis, they'll write a report showing the kinds of injuries you suffered and the treatment you need. This report comes in handy when negotiating a settlement with the insurance company. Without it, the insurer could claim that the injury wasn't that serious or didn't even exist. In that case, it will be much more difficult for the car accident attorney to prove them wrong. 

Appealing a Car Insurance Claim Decision in Cincinnati, Ohio

You have the right to file a dispute if your insurance company or the other party's insurers denies your claim. Here's how:

Contact the Insurance Company

When the insurer disputes your claim, they'll provide a reason for the dispute. They can't just deny the claim without any reason. Contact them and let them know that you're not satisfied with their decision. 

The reason for the dispute should also help you draft the most appropriate response. For example, you may be able to provide copies of receipts for the treatment you sought after the injury if they cite the lack of medical evidence as the reason for disputing the claim. You can also provide copies of the doctor's report. When they realize that you might have a genuine case against them, most insurance companies will want to quickly settle the case to prevent you from contacting a car accident attorney. This is because there's always a higher chance that they'll have to pay even more than you may be entitled to when an attorney is involved. 

Contact the Ohio Department of Insurance

The other option is to contact the Ohio Department of Insurance to file a complaint against the insurance company. However, this alternative has some limitations. Here are a few examples:

The Ohio Department of Insurance cannot dispute a claim when your only evidence is your word against the insurer's. This is quite heartbreaking, especially when you know that you're speaking the truth and you just need someone to believe in you. 

The ODI cannot also pass medical judgments requiring the insurer to pay for medical services the insurer claims are medically unnecessary. Unfortunately, this isn't usually a fair decision. Most people forget that insurance companies are in business. For this reason, they'll do anything to avoid spending their money despite earning millions or even billions every year. 

Sometimes, the insurance company might refuse to pay for your medical expenses not because they're unnecessary but due to certain technicalities somewhere along the way. Even though such companies might seem to care when you find out about them from commercials, they usually protect their interests more than anything. The only time insurers care is when collecting money from you. But when it's time to compensate you for your losses, they'll do everything they can, even if it means clinging onto some technicalities, to avoid paying what they owe you as compensation for your injuries. 

Here are some common tactics insurance companies use when you file a claim:

Lowballing

Offering a low-ball settlement when you urgently need money to offset your bills, such as medical expenses, rent, etc. They do this knowing that there's a better chance that you may accept the offer because you're desperate. 

Quick Settlements 

Some companies might also pressure you into settling the claim to deny you a chance to speak with an experienced attorney. They know that talking to an attorney could significantly increase the value of your claim. While most insurance companies will only want to settle your medical bills, an experienced attorney can add other economic and non-economic damages to the list. 

Signing Waivers 

Other insurers will pressure you into signing waiters or similar statements to prevent you from recovering additional compensation later. 

Lastly, the Ohio Department of Insurance can't provide legal advice or resolve disputes that are in the process of a lawsuit. But you shouldn't worry if you've exhausted all your options. There's one more option worth considering. 

Contact an Experienced Ohio Car Accident Attorney

As mentioned before, insurance companies like to play games when you need compensation for your injuries. The Ohio Department of Insurance might be helpful but only to a certain extent. For instance, they can't help you if you don't have evidence against the other party.

That's where a car accident attorney comes in handy. Here's how they can help: 

Investigating the Accident

An experienced car accident attorney can investigate the accident and collect crucial evidence to prove your eligibility for compensation. When you confront the insurance company with proof, it becomes much more difficult to dispute a claim. This is the most common reason the insurer doesn't want you to hire an attorney. 

Discussing Your Legal Options 

Another common reason insurance companies like to play games is because they assume that accident victims are usually unaware of their legal rights. This could be true - most accident victims may even abandon their claims halfway due to frustration and lack of awareness. 

You don't expect the insurance company to inform you that your case could be worth more than what you're claiming. Similarly, you don't expect them to walk you through certain steps if it could mean losing more money. Again, that's something an attorney can help you with. 

Dealing With the Insurance Company Directly

It's easier to intimidate an accident victim than an attorney. This is because attorneys know how car accident laws work. When insurance providers realize that you have an attorney fighting for you, they'll begin to take your claims more seriously.

Negotiating a Settlement Offer on Your Behalf

You may not know what you're entitled to as compensation for your injuries, but an attorney does. Your lawyer will consider every possible damage you've suffered due to the accident. They'll then use this information to calculate the most reasonable settlement and negotiate it with the insurer.

Contact a Morgan & Morgan Car Insurance Attorney in Cincinnati, OH

Although it's always advisable to contact an attorney to appeal a denied car insurance claim, the attorney or law firm you choose to work with could significantly impact your claim. You want to work with a law firm with vast legal resources, an experienced team of attorneys, and a proven track record. That's where Morgan & Morgan - the largest personal injury law firm in the United States - comes in. Fill out our free consultation form today, and one of our representatives will get in touch to discuss your case. 

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Last updated on Dec 07, 2022