If you have a homeowner’s policy, you expect to be covered for the loss of some item that gets stored or displayed in your home. If you have a car insurance policy, you expect to get covered for the damages and losses that result from an on-road accident. What happens if an adjuster says that your expected coverage has been denied?
Negotiations do not stop.
All negotiations consist of the presentation by one side of a certain argument. If the adjuster has said that your coverage will be denied, your Personal Injury Lawyer in Mount Pearl must argue that you deserve to be covered. In other words, an additional argument must get discussed during the course of the negotiations.
What to do in response to the adjuster’s prediction of a denial?
Call the adjuster and ask for a written explanation of why you should expect to be denied coverage. If you are lucky, you will receive a statement that mentions one of these common reasons: Your policy has lapsed; the accident’s location is not covered; the person responsible for the accident is not covered; no third-party claim is allowed. (This reason might be given in a state with no-fault insurance.)
If you do not get that written statement, you must write a letter to the adjuster. Put in writing your request for an explanation, regarding why you could be denied.
As negotiations continue, you will get another call from the adjuster. At that time, you should demand a response to your most recent letter. If you get no oral or written response, you will have to compose a second letter. In that second letter, you must make clear the efforts that you have taken so far, in order to learn the basis for the adjuster’s predication.
If you are dealing the company that has insured the responsible party, ask for a copy of that applicable parts of that person’s policy. If you receive copies of those relevant sections of the policy, be sure to read them.
If you find that the adjuster’s correction proves true, you will have to see who else might be deemed responsible for the accident. If you find that the adjuster had made a false statement, you may have grounds for suing the insurance company. In either case, you could benefit from the services of a lawyer.
You could also appeal the denial. If you wanted to win that appeal, you should have devoted time and money to finding and hiring a reputable lawyer. An injury lawyer can work with you to fight for the denied coverage, by reviewing the exact reason for the denial, and then pointing out the weakness in the insurer’s argument.