You pay your insurance premiums on time, expecting your provider to step up when you need them most. But what happens when your claim is denied? Whether it’s a car accident, personal injury, or homeowners insurance issue, having your claim rejected can be stressful and financially overwhelming, especially when you’re trying to recover physically and emotionally.
At Johnson & Lundgreen, we’ve worked with injured clients throughout Boise, Meridian, Nampa, and Twin Falls who’ve had their claims unfairly denied. If you’re facing a similar situation, here’s what you need to know and what you can do next.
Why Do Insurance Companies Deny Claims?
Insurance companies are businesses, and like any business, they want to protect their bottom line. While some denials may be legitimate, others are simply tactics to delay or reduce payouts. Common reasons for denial include:
- Disputing liability: The insurer claims their policyholder wasn’t at fault or says you were partially or fully to blame.
- Insufficient documentation: They say you didn’t provide enough evidence of the damages or medical treatment.
- Policy exclusions: Your situation doesn’t fall under what your policy covers (according to them).
- Lapsed policy: The insurer claims your policy wasn’t active at the time of the incident.
- Delayed reporting: They argue you waited too long to report the incident or file a claim.
If you believe your claim has been wrongfully denied, don’t give up hope. You have options—and an experienced attorney can help.
Step 1: Understand the Reason for Denial
Start by reviewing the denial letter carefully. It should explain why the claim was denied and reference specific policy provisions. Sometimes, the issue is as simple as missing paperwork or a technical error that can be corrected.
If the explanation is vague or doesn’t seem to match your understanding of the policy, it may be a red flag, and it is worth having an attorney review the situation.
Step 2: Gather Supporting Documentation
Next, collect all documents related to the claim. This includes:
- The insurance policy
- The denial letter
- Police or incident reports
- Medical records and bills
- Photos or video evidence
- Witness statements
- Any correspondence with the insurance company
This documentation will be essential whether you’re submitting an appeal or pursuing legal action.
Step 3: File an Appeal with the Insurance Company
Many insurance policies have an internal appeals process. This gives you a chance to challenge the denial without going to court. You’ll typically need to submit a written appeal, explain why the denial was incorrect, and include any new or overlooked evidence.
However, keep in mind that insurance companies rarely reverse decisions unless faced with strong pressure or evidence. That’s why working with a lawyer during this stage can be extremely beneficial.
Step 4: Consider Filing a Complaint or Lawsuit
If your appeal is denied or ignored, you may need to escalate the matter.
- File a complaint: You can file a complaint with the Idaho Department of Insurance if you believe the insurer acted unfairly or in bad faith.
- File a lawsuit: If the denial caused financial harm and the insurer refuses to settle, you may be able to sue for breach of contract or bad faith. In Idaho, insurers can be held legally accountable for denying valid claims or failing to act in good faith.
Our team at Johnson & Lundgreen will assess your case and help determine the right legal path forward.
What Is a Bad Faith Insurance Claim?
Insurance companies have a legal duty to treat policyholders fairly. When they deliberately delay, underpay, or deny legitimate claims without reason, it may be considered bad faith. Examples include:
- Misrepresenting policy language
- Ignoring your claim or delaying payment
- Offering an unreasonably low settlement
- Failing to investigate the claim properly
If an insurer is found guilty of bad faith, they may be forced to pay not only your claim but also additional damages, including attorney’s fees and punitive damages. Another related claim is for Negligent Adjustment. We can help you you with these types of claims.
How Johnson & Lundgreen Can Help
If your claim has been denied, you don’t have to face the insurance company alone. At Johnson & Lundgreen, we’ve helped countless Idaho residents fight back against denied and undervalued claims. We’ll review your denial, gather evidence, and build a strategy tailored to your case. We handle all communication with the insurer and advocate for your full financial recovery.
We serve clients in Boise, Meridian, Nampa, Twin Falls and all surrounding cities and counties, and consultations are always free. If we take your case, you don’t owe us a dime unless we win. However, Idaho law limits how long you have to dispute a denial or take legal action. The sooner you reach out, the more options you may have.
Take Action Today
Insurance companies might hope you walk away quietly after a denial, but with the right legal guidance, you don’t have to. If your injury claim has been denied, contact Johnson & Lundgreen today. We’re here to protect your rights and get you the compensation you’re owed.