When an insurance adjuster denies an accident claim, don’t take his or her word as the final say on your case. Time after time, my clients have gotten their claims paid after an adjuster initially issued a denial.
I suspect that a majority of claims are denied simply out of routine. It is financially efficient for insurance carriers to deny a number of claims because the majority of people will believe that the adjuster is right and won’t pursue the matter further. Two of the most common excuses that I see adjusters use when denying a valid claim are 1) they are unable to determine their insured’s liability for the accident, and 2) the accident is not consistent with an injury causing event. Excuse number 1 usually means that the adjuster took a cursory look at the accident file and felt that there was not enough information for him to decide who was at fault. Excuse number 2 usually means that there was a small amount of damage to the vehicles involved, and the adjuster (who is not a doctor) decided that it was impossible for anyone to be legitimately injured. The truth is, initially denied claims get paid all the time once an attorney gets involved. What frequently happens is that the claim is reassigned to a new adjuster who reevaluates the claim. Typically, once an attorney begins working on the denied claim and files a lawsuit, the insurance carrier reevaluates, reverses direction and offers a settlement. Remember this: valid claims are routinely denied, and denied claims are routinely paid once an attorney gets involved.