Qué hacer si su reclamación al seguro es rechazada en casos de lesiones personales en California

After an incident occurs, victims need to know that they’re covered by their insurance. Even though we pay these companies to help us when we need them, they’re ultimately looking for any reason to avoid paying. You wonder what to do if your insurance claim is denied in personal injury cases in California.

Hire a Personal Injury Lawyer in California

For over 24 years, the team at Ley Amendt has helped California residents navigate their unique cases in insurance claims and court. We understand how complex the legal process becomes once you experience an injury. We’ve fought to secure:

• $250,000 for a client who was a victim of a car accident. His insurance company initially offered him only $3,000, not taking into account the true extent of his injuries.
• $500,000 for an elderly client who suffered full-body injuries after a car drove through a building and hit them. The building’s insurance initially refused to pay, but our team was able to prove that the incident could’ve been avoided with proper safety measures.

Let our skilled derecho de daños personales team be the ones to fight on your behalf for what you deserve.

Why a Claim May Be Denied in a California Personal Injury Case

In 2022, there were 26.2 million trips to the emergency room for an unintentional injury in the United States. When these injuries happen, you need to be able to rely on your insurance company to protect your finances. In 2024, Kaiser Permanente denied around 842,326 claims in California. Claims are denied for several reasons, including:

• Insufficient evidence showing that the other party caused the accident. For example, if a victim of a car accident fails to provide proper evidence, such as traffic camera footage of the other driver hitting them, they may have their claim denied. It’s important to hire a personal injury lawyer to help you understand what evidence is needed in your case.
• Disputed injuries. Insurers often argue that your injuries aren’t serious or weren’t caused by the accident.
• Policy exclusions or lapses. Some policies limit coverage for certain drivers or have restrictions on specific situations.
• Missing deadlines. Insurance companies have strict filing and documentation deadlines, and California law requires most personal injury claims to be filed within two years of the accident.

What to Do if Your Insurance Claim Is Denied

If your claim is denied, start by carefully reading the denial letter to understand the reason. Then, contact the insurance adjuster to clarify the denial.

If the denial still seems unfair, consult a personal injury attorney to help you gather:

• Historial médico
• Accident reports
• Witness and professional statements
• Photos or videos of the accident scene

Next, write an appeal letter. Submit your appeal within the deadline listed in the denial letter.

If the insurance company still denies your claim, you can file a complaint with the California Department of Insurance. This agency reviews cases and can help if the insurer is acting in bad faith.

Bad faith insurance cases can include them denying a valid claim without investigation, delaying the process, or offering an unreasonably low settlement. Your lawyer can assist during this process.

Choose an Experienced Personal Injury Law Firm in California

Reach out to the team at Amendt Law today to schedule your confidential consultation at our Pomona office. After suffering an injury, you deserve to have a strong legal advocate do the heavy lifting for you. We’re dedicated to fighting for the rights of our neighbors and community members.