What do I do if Insurance Denies My Injury Claim?

Suffering an injury is stressful enough without the added burden of fighting for the compensation you need to recover. When your insurance claim is denied, it can feel like the system is stacked against you, especially as medical bills pile up and impact your ability to work.

A denied injury claim in Utah can complicate your recovery both financially and emotionally, especially if you’re unfamiliar with the personal injury claim process or unsure how to move forward.

Insurance companies are supposed to provide financial relief in times of need, but many claimants find themselves facing rejections that seem unfair or unclear. In Utah, where legal nuances such as comparative negligence can complicate claims, understanding your rights is crucial.

Let’s walk through the common reasons insurance companies deny injury claims, explain possible legal options, and offer actionable steps to help you appeal the denial and pursue the compensation you deserve. Whether you’re dealing with a minor car accident or a more serious personal injury, you don’t have to navigate the process alone.

Why Insurance Companies Deny Injury Claims

Insurance companies often deny claims to minimize payouts and protect their profits. While some denials are legitimate, others may stem from misinterpretations or unfair practices.

Common Reasons for Denial

• Insufficient Evidence: Lack of medical records, police reports, or witness statements to support your claim.
• Policy Exclusions: The insurance policy may not cover specific injuries or circumstances, such as pre-existing conditions.
• Missed Deadlines: Failing to file the claim within Utah’s time limits or missing reporting deadlines.
• Disputed Liability: The insurer argues you were partially or fully at fault for the accident.
• Lowball Offers: The insurer denies the claim outright, hoping you’ll accept a smaller settlement.
• Settlement Delays: While not a “denial,” this can have the same effect when some insurers slow the process intentionally, hoping you’ll give up or accept less than your claim is worth.

Understanding Utah’s Fault and Liability Rules

Utah follows a comparative negligence system. If you’re found partially at fault for an accident, your compensation may be reduced by your percentage of fault. For example, if you’re 20% at fault, you can still recover 80% of damages.

However, if you’re 50% or more at fault, you may be barred from recovery.

Insurers often exploit this rule to deny or reduce claims. Disputing liability is one of the most common tactics insurers use to minimize payouts or deny claims outright.

How to Respond to a Denied Injury Claim

A denial isn’t the end of the road. Taking strategic steps can help you challenge the insurance company’s decision.

Review the Denial Letter Carefully

The denial letter should explain why the insurance company rejected your claim. Look for:

• Specific policy clauses cited by the insurer in the claim denial letter.
• Missing documentation that they claim is needed.
• Errors in their assessment, such as incorrect dates or facts.

If the explanation is unclear, request written clarification from the insurer.

Gather Stronger Medical and Legal Evidence

Bolster your claim with:

• Medical Records: Updated doctor’s reports, diagnostic tests, and treatment plans linking your injuries to the accident.
• Expert Testimony: Statements from medical or accident reconstruction experts to support your case.
• Witness Statements: Testimonies from bystanders or coworkers who saw the incident.
• Photos and Videos: Visual evidence of the accident scene, injuries, or property damage.

Be prepared to address medical documentation issues that insurers may use to question the legitimacy of your injuries. Keep detailed records of all communications with the insurer.

File a Formal Appeal With the Insurance Company

If your insurance company has rejected your claim, you have the right to appeal a denied insurance claim through their formal process.

To file an appeal:

• Submit a written appeal within the deadline (typically 30–60 days from the denial).
• Include new or corrected evidence to address the denial reasons.
• Reference specific policy provisions that support your claim.
• Request a response timeline and keep copies of all submitted documents.

If the appeal is denied, you may have further options such as filing a complaint with the Utah Insurance Department or the National Association of Insurance Commissioners.

Can You Sue an Insurance Company in Utah?

When an insurer unfairly denies your claim, legal action may be necessary to secure compensation. You may be able to sue the insurance company in Utah if they reject your claim without a valid reason or fail to act in good faith.

Understanding Bad Faith Insurance Practices

Utah law requires insurers to act in good faith, meaning they must handle claims fairly and in a timely manner. If you believe your claim was denied unfairly, an insurance bad faith lawyer can help you hold the insurer accountable under Utah law.

Bad faith practices include:

• Unjustified denials or delays in processing claims.
• Offering unreasonably low settlements.
• Misrepresenting policy terms or coverage.

If you suspect bad faith, you may be able to sue the insurer for damages beyond your original claim, such as emotional distress or punitive damages.

When to Pursue a Personal Injury Lawsuit

If the insurer continues to deny a valid claim, you can file a personal injury lawsuit against the at-fault party or a bad faith lawsuit against the insurer. In Utah, the statute of limitations for personal injury claims is four years from the date of the accident, but bad faith claims may have different deadlines.

Consult a lawyer to determine the best approach.

When to Hire a Salt Lake City Injury Lawyer

When your insurance claim has been denied and the appeals process seems overwhelming, a Salt Lake City personal injury lawyer can step in to protect your rights and build your case. Navigating a denied claim can be complex, especially when insurers use tactics to avoid paying.

How Valley Law Accident & Injury Lawyers Can Help

At Valley Law Accident & Injury Lawyers, we specialize in helping Utah residents fight denied injury claims. Our team can:

• Review your denial letter and identify errors or bad faith practices.
• Gather compelling evidence to strengthen your appeal or lawsuit.
• Negotiate with insurers for a fair settlement.
• Represent you in court if litigation is necessary.

Our personal injury lawyers are experienced with the statute of limitations in Utah and ensure all actions are filed within the appropriate timeframes. With our experience in Utah’s insurance and injury laws, we’re committed to securing the compensation you need for medical bills, lost wages, and pain and suffering.

FAQ About Denied Injury Claims in Utah

How long do I have to appeal a denied claim in Utah?

Most insurers set a 30–60-day deadline for appeals. Check your denial letter for specifics.

What is an independent medical exam (IME), and can it affect my claim?

An IME is a medical evaluation conducted by a third-party doctor, often requested by insurers. The findings from an IME can significantly impact the outcome of your claim, especially if they contradict your primary physician’s diagnosis.

What kind of evidence for injury claims do I need?

The most persuasive evidence includes detailed medical records, accident reports, witness statements, and photographic or video proof. If you can’t collect these yourselves, your car accident lawyer can do so for you.

Can I appeal a denial more than once?

It depends on the insurer’s policy. Some allow multiple appeals, while others limit you to one.

What if I can’t afford a lawyer?

Many injury attorneys, like ours at Valley Law, offer free consultations and work on contingency, so you pay only if you win.

Can I sue the at-fault party instead of the insurer?

Yes, if the insurer denies your claim, you can pursue a personal injury lawsuit against the responsible party within Utah’s four-year statute of limitations.

What damages can I recover in Utah?

You may recover medical expenses, lost wages, property damage, pain and suffering, and, in bad-faith cases, punitive damages.

Get a Free Consultation Today

Don’t let a denied claim stop you from getting justice. Contact Valley Law Accident & Injury Lawyers for a free consultation. Call us at (801) 810-9999 to discuss your case with no obligation.

We work on a contingency fee basis, meaning you pay nothing unless we secure a favorable outcome.

Don’t let a denied claim derail your recovery. With the proper evidence and legal support, you can fight back and get the compensation you’re entitled to in Utah.