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8 Common Reasons Why Insurance Companies Deny Injury Claims

— May 20, 2022

You must have an existing insurance policy to file a claim.

Getting an injury insurance claim can help you handle the expensive medical expenses, repair damaged vehicles or property and even provide for your family after an accident. However, obtaining compensation is not always straightforward, as your insurer could deny your claim. Read on for eight reasons why your injury claim could be rejected.

  1. Lapsed insurance coverage

Your insurance providers may fail to compensate you if it establishes that your insurance coverage has lapsed. Some of the reasons insurance coverage lapses include:

  • Failing to pay insurance premiums by the specified time
  • The insurance company is no longer in existence
  • The insurance company cancels your policy 
  1. Lack of a medical evaluation 

Whether you are in any pain or not after a car accident, it is essential that you seek medical attention immediately. Some injuries become evident hours, days, or even weeks after the incident. Visiting your doctors allows them to perform a complete medical evaluation to determine underlying issues from the crash and recommend the best treatment. Your physician will write a detailed medical record which you could present to your car accident attorney from Riccio Law so that they file evidence to help maximize your compensation.

If you fail to get the medical evaluation or wait for too long, the insurance company can dispute the severity of your injuries. They could even claim that your injuries are not a result of the accident; therefore, they deny your claim.

  1. Pre-existing medical conditions

Insurance companies are always looking for ways to reduce compensation or avoid it altogether. They dedicate time to discovering evidence that compromises your chances of being compensated, including going through your medical history. If they find that you had an injury or surgery before the accident or you suffer from a chronic illness, they could argue that the condition is the reason for your pain and not the collision.

  1. Failing to notify the insurer soon enough

You are obliged to notify your insurance provider after an auto accident. However, do not wait until the other party involved in the car accident reaches out to your insurer to do so, as you could be blamed for the crash. Failing to notify your insurance company about the accident immediately could result in your insurer arguing that they did not have the chance to look into the claim when the scene and evidence were still fresh.

  1. False information

When it comes to determining how much to compensate you after a personal injury, your insurer’s investigations will not be limited to the accident period. They will look into each detail of your policy from the moment you file your application. If they discover you concealed or falsified information, they will deny your claim. Some insurance providers could even go ahead and cancel the policy. 

  1. You are partially or wholly responsible for the accident

Be sure to read and understand an insurance policy’s terms to avoid circumstances or behaviors that could compromise your coverage. Your insurer will not be obliged to compensate you if you void your coverage. 

If an accident results from texting while driving, especially in countries where using the phone when driving is prohibited, or drunk driving, your insurer will not compensate you. The insurance company may also deny an injury claim if the crash occurred when an unlicensed driver you have allowed to use your car was driving or when you were committing fraud at the time of the accident. Your claim could also be rejected if it is established that there were other ways you could avoid the collision, but you did not. 

  1. Lack of insurance

You must have an existing insurance policy to file a claim. If your insurance policy does not cover a specific risk, your insurer cannot compensate you. For instance, if your insurance policy does not cover fire, any injury claim for this reason will be denied. For this reason, always dedicate time to reviewing your insurance policy to ascertain that it covers all potential risks. For your motor insurance, determine whether the insurance company provides underinsured or uninsured motorist coverage and choose it to reduce the chances of your claim being denied.

  1. Liability dispute

    Two-car accident; image courtesy of State Farm, via Flickr, CC BY 2.0, no changes made.
    Two-car accident; image courtesy of State Farm, via Flickr, CC BY 2.0, no changes made.

Suppose the parties involved in the accident (you and the other driver) disagree on whose fault the collision was. In that case, the insurance companies also dispute whose obligation it is to cover the compensation. This could result in both parties rejecting the insurance claim.


Obtaining an injury claim can make handling the impact of an accident more bearable. Familiarize yourself with the above reasons why your insurer could deny your claim and hire a Ricco Law attorney to help you get what you are duly owed.

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