When you get hurt, there is often an insurance policy available to cover you. In most situations, that policy is someone else’s; in a minority of situations, it’s your policy. This changes your options, but there are options in either case.

When someone else injures you, and their insurance denies your claim, our lawyers can use internal insurance appeals and negotiate directly to try to get the claim accepted. If they refuse to cover you, we can sue and fight the case in court. When your own insurance denies coverage, we can do the same. However, this often plays out differently and may give you the right to file a bad faith insurance claim.

For a free case review, call our Arizona personal injury lawyers at Phoenix Accident and Injury Law Firm at (480) 428-0816 today.

What if the Defendant’s Insurance Denies My Claim?

When someone else injures you, and they have insurance to cover the accident, you file a third-party claim with their insurance. Their insurance company analyzes the facts, does its own investigation, and pays you if two circumstances are met:

• Their policyholder is likely responsible
• The cost of paying the settlement is probably cheaper than trying to fight the case further.

Essentially, this means insurance companies will only pay up if they give up fighting the case. If they want to keep fighting, they will deny claims.

This leaves you with a few options:

Use the Insurance Company’s Processes

The insurance company may have processes and procedures for requesting reconsideration or appealing denials of third-party claims. However, this is often the weakest option and simply asks the insurance company to take another look at a claim they’ve already denied.

Negotiate

Once you call our Phoenix personal injury lawyers and get us on the case, we can contact the insurance company and negotiate directly with them. We can review the case and demand full payment for all damages, show the insurance company the evidence we have against them, and try to persuade them to settle without making a bigger fight.

Lawsuits

If the insurance company refuses to pay you, we can sue the defendant. The insurance company will then likely be required under the policy to pay for their lawyer and to pay damages when we win the case at trial.

However, most cases settle before trial. After filing a lawsuit, the insurance company often sees the potential expenses climbing and settles before things get too expensive for them.

What if Your Insurance Denies Your Claim?

In some cases, you are actually filing with your own insurance rather than the defendant’s. This is common for defendants who use their insurance to cover the damages they caused.

However, our plaintiff’s-side injury lawyers focus on a different situation: first-party insurance coverage. This includes auto insurance coverages, such as medical payment coverage or uninsured motorist coverage, where your insurance company pays you when you get hurt.

Denials often have the same three options, but they work a bit differently in first-party claims:

Use the Insurance Company’s Processes

You can often appeal denials and request reconsideration through your insurance company. Your policy might give you greater rights and leverage when it’s your own policy than when it’s the defendant’s policy.

However, this all still leaves your claim in the insurance company’s hands.

Negotiate

Our attorneys can similarly contact your own insurance company and make demands. Because there is an insurance policy – a contract between you and the insurance company – we often have stronger grounds to demand compensation under the policy’s terms.

Many of these policies are also no-fault, meaning we just need to prove

• The facts fit the policy’s coverage
• The amount of damages.

Lawsuits

When suing your own insurance company, you can do so for breach of contract if they violate the terms of the policy. However, many cases involve worse conduct, violating the insurance company’s duty to make a good faith effort to pay your claim.

These “insurance bad faith” claims can often result in the full original price, plus punitive damages to punish the insurance company for its bad faith. However, strong evidence is needed, such as proof that they

• Retroactively canceled your policy
• Destroyed records
• Refused to respond to calls or other communications
• Never started an investigation
• Unfairly delayed communications and denials
• Tried to shirk responsibilities under the insurance policy
• Etc.

FAQs for Overturning Insurance Denials in Arizona

Can You Always Sue for Insurance Denials?

Suing is not always an option, such as in Workers’ Compensation cases, where lawsuits are barred against an employer. However, there may be lawsuits you can still file against other at-fault parties, outside of the parties whose insurance denied your claim.

Otherwise, our at-fault system usually allows lawsuits directly against the defendant, even if they have insurance.

When Does Insurance Cover My Case?

Defendants often have insurance to cover the injuries they cause in these three categories:

• Accidents on their property (homeowners insurance or business liability insurance)
• Accidents caused by their business operations (business liability insurance)
• Auto accidents (car insurance).

However, there may be other situations that are also covered by insurance.

Can I Sue the Defendant Directly Instead of Waiting for Insurance?

If someone injured you, you can often sue them directly for what they did. There are some exceptions (such as being unable to sue your employer for a work-related injury), but the fact that they have insurance doesn’t usually stop you from suing.

This means you can often try to settle the claim through insurance first. Then, if the case is denied or insurance gives you the runaround, you can take the defendant to court.

Do I Sue the insurance Company or the Defendant?

If you are trying to get damages from the defendant’s insurance, you file a third-party insurance claim with their policy. If they deny the claim or give you the runaround, you typically sue the defendant directly, then their insurance steps in to cover them.

If you are trying to get damages from your own insurance, you would deal with your insurance directly. If they breach the insurance policy’s terms or commit bad faith, you can often sue them.

However, the defendant who caused your injuries might also be on the hook for damages, and you may also be able to sue them, even if you make a first-party claim as well.

Call Our Arizona Personal Injury Attorneys Today

Call (480) 428-0816 for a free case evaluation with the Glendale personal injury lawyers at Phoenix Accident and Injury Law Firm.