You did everything right after your car accident. You filed your insurance claim on time, gave the company all the documents they asked for, and waited for your settlement while you focused on healing.
Then the letter arrived, denying your claim. You feel frustrated, confused, and worried about how you’ll pay your bills now.
At Shapiro, Washburn & Sharp, our Virginia Beach car accident attorneys have spent decades helping Virginia residents deal with these exact situations, and we know that denied claims are not as rare as you may think. According to 2023 data from the Bureau of Insurance in Virginia, insurers reported over 46 million claims that year, of which about 9.1 million (19.7 percent) were denied.
With recognition from organizations like Super Lawyers and Best Lawyers, our team has the dedication needed to turn many denied claims into successful recoveries. Let’s walk you through what you need to know if your car accident claim has been denied in Virginia.
For more information on your particular case, contact us at 833-997-1774 for a free consultation today.
Why Do Claims Get Denied?
Before you can fight back against a denial, it helps to understand why insurance companies deny claims in the first place. They are businesses, and just like any business, they want to protect their bottom line. Sometimes they will deny a claim for legitimate reasons, but other times they will do so simply in the hopes of saving money.
One of the most common reasons for denial is the insurance company arguing that their policyholder wasn’t to blame for the accident. They may say that you were partially or fully responsible for what happened, which, if true, would bar your ability to recover any compensation in Virginia.
Another frequent reason for denial is that the insurance company says you weren’t hurt as badly as you say you were. They may acknowledge that the accident occurred, but claim your injuries weren’t as serious as you say they are, or that they weren’t caused by the accident at all.
Sometimes, an insurance company may deny a claim because of policy-related issues. They may say you filed your claim too late, you didn’t have the right kind of coverage, or that certain damages aren’t covered under your policy. They may also say you didn’t follow the proper procedures after the accident, such as failing to call the police or seek medical attention.
What Does a Denial Mean?
A denied claim means the insurance company is refusing to pay what you asked for. Sometimes they may deny the whole claim (saying they owe you nothing), or they may deny a key part of it, like the medical bills, lost wages, or pain and suffering.
Virginia has rules about how insurance companies have to handle denials. For example, the denial must be in writing, and the company must give a reasonable written explanation of why they denied your claim, including a specific reason that they did so.
The most important thing to understand is that a denial letter isn’t a judge’s decision. It is the insurer’s decision. They may be wrong, however, and often an initial denial is like an opening move in a negotiation. They may be hoping you’ll accept their decision and walk away, but you have options.
What Should I Do After I Get the Denial Letter?
When you get the denial letter, read it carefully and highlight the specific reasons they give you for the denial. Then, keep this letter in a safe place with your other accident-related documents for future reference.
Next, assume that you’re in a race against time. You need evidence to prove your claim, and evidence fades and even disappears over time. Cars get repaired, skid marks fade, video footage is recorded over, and witnesses forget details. Meanwhile, you can bet that the insurance company will continue to gather whatever evidence they can to support their denial.
Think of your denial letter like a starting gun. You want to gather and protect evidence quickly—things like crash photos, vehicle damage photos, police reports, witness contact info and written statements, and medical records. Don’t forget to save pay stubs showing lost wages if you missed work because of your injuries, receipts for rental cars or other transportation expenses, and estimates for vehicle repairs. The more documentation you have, the stronger your case becomes.
How Do I Appeal the Denial?
Most insurance companies have an internal appeals process that allows you to challenge a denial. This is usually your first step. The denial letter you received should have information in it about what you need to do to appeal and the deadlines you need to meet.
This is the perfect time to consider hiring a Virginia Beach car accident attorney if you haven’t already. You can try to handle the appeals process on your own, but having an attorney on your side can dramatically improve your chances of success. Remember that insurance companies have entire legal teams working to protect their interests, and they’re experts at finding reasons to deny or minimize claims. If you have an experienced lawyer on your side too, you level the playing field.
Your Virginia Beach car accident attorney will know how to craft an appeal letter that addresses each of the insurance company’s concerns in the most compelling way possible. More importantly, when the insurance company sees that you’ve hired legal representation, they will know you’re serious about fighting for your rights, and they may become more willing to negotiate fairly with you.
In the appeal letter, your attorney will explain why you believe the denial was wrong, and give reasons to back up that argument. They’ll also include any evidence needed to support your argument. Be aware that the insurance company may focus on claiming you share in fault for the accident. Virginia follows a “contributory negligence” rule, which means if you are even one percent at fault for the accident, you can’t recover damages from the other driver. So they often try to show that you are somewhat at fault, but that doesn’t mean they’re right.
A good car accident attorney will gather the evidence needed to prove that you were not at fault and that the other driver was entirely responsible, which will then allow you to seek the compensation you deserve.
How A Car Accident Lawyer Can Help
Insurance companies often deny or downplay claims because they assume the injured person won’t push back. When you have Shapiro, Washburn & Sharp on your side, things change.
In one particular case, our Virginia Beach car accident lawyers represented a driver who was rear-ended and hurt his back. The insurance company tried to argue that the pain was not really caused by the crash. We gathered medical records, doctors’ opinions, and crash evidence that showed the collision made our client’s previous injury much worse and affected their ability to work. After presenting the full picture, the case resolved for $675,000, helping our client to pay medical bills, make up for lost income, and move forward.
If you or a loved one was seriously injured in a car accident, contact our offices right away. Or you can meet us in person at one of our offices in Virginia Beach, Suffolk, Chesapeake, Hampton, Portsmouth, and Norfolk.
