The process of submitting a claim provides insurance companies with some easy excuses for denying a submitted claim. It also contains certain nebulous areas that some insurance companies have chosen to exploit.
Easy excuses
A Claims Department might insist that the submitted paperwork was incomplete. Then the potential claimant would have to try to identify the portion of the submitted form that had lacked a sufficient amount of information.
Alternately, a Claims Department might say that the claimant had failed to submit the paperwork in time. A good personal injury lawyer in Menifee could help any claimants that might have to deal with that excuse.
A third approach could have the Claims Department telling the claimant that he/she had failed to follow directions, when submitting the completed forms. That failure would then serve as the basis for a denial of coverage.
Nebulous areas that an insurer might exploit
There might exist evidence that could be used to support an allegation of shared fault. In other words, the insurance company would allege that the victim was partly to blame for the accident, or for the severity of the resulting injury.
If the adjuster had learned that the injured party had suffered a previous injury, then that knowledge would provide the same adjuster with another reason for denying coverage or the reported injury. The adjuster could allege that the other injury’s effects had persisted, and had caused the severity of the more recent harm to the victim’s body.
If the adjuster had learned that the victim had been living with a pre-existing condition, then that fact could serve as the basis for yet another tactic. The adjuster might claim that the victim should have been wearing some type of protective device. Alternately, the adjuster’s argument might insist on the need for a stronger seat belt over the body of the now-injured driver.
Protections for claimants
A willingness to hire a lawyer should help a claimant to gain access to at least some measure of protection. Still, anyone that has chosen to consult several lawyers should know what to look for, in the ideal legal counsel.
An ideal attorney should have access to someone in the medical community, so that an adjuster’s claims could be confirmed or refuted. The best attorney would be one that had dealt with another client that had a medical history that was similar to that of the prospective client.
That history might include mention of another injurious condition, one that had resulted from an accident. Alternatively, the other client’s history might have made mention of a pre-exiting condition, possibly one that had some of the same symptoms as the condition that had been mentioned in the victim’s own medical history.