Egan Explains: What to Do When Car Insurance Won’t Pay

Facing a car insurance claim denial after an accident can be both frustrating and overwhelming. Understanding the reasons behind such denials is crucial. Common causes include administrative errors, lack of preauthorization, services deemed not medically necessary, or treatments considered experimental. Familiarizing yourself with your policy’s terms and the specific reasons for denial is the first step toward resolution.

Review the Denial Notice Thoroughly

Upon receiving a denial, carefully examine the explanation of benefits (EOB) or denial letter from your insurer. This document outlines the specific reasons for the denial and provides information on how to appeal the decision. Understanding these details is essential for determining the appropriate course of action.

Initiate an Internal Appeal

If you believe the denial is unjustified, you have the right to file an internal appeal with your insurance company. This process involves requesting the insurer to review and reconsider their decision. Ensure you adhere to any deadlines and provide all necessary documentation to support your case.

Seek an External Review if Necessary

Should the internal appeal be unsuccessful, you can request an external review. This involves an independent third party evaluating your claim and the insurer’s denial. The decision made during an external review is typically binding, meaning the insurance company must comply with the outcome.

Consult with a Legal Professional

Navigating car insurance denials after an accident can be challenging. Consulting with a knowledgeable attorney can provide valuable guidance tailored to your specific situation. At the Law Offices of Kenneth G. Egan in Las Cruces, NM, we are dedicated to assisting clients in understanding their rights and exploring all available options when facing car insurance claim denials. We are located in Las Cruces and are proud to service the surrounding areas, including Doña Ana, Santo Tomas, La Mesa, Fort Selden, Radium Springs, and beyond.