If you or someone you love has suffered a traumatic brain injury (TBI) in a car accident or slip-and-fall incident, you know how profound the impact can be. Medical expenses and lost wages can pile up fast, and your quality of life may change drastically. Unfortunately, while TBI victims often receive the compensation they need and deserve, insurance claim denials are more common than you may expect. Having your TBI insurance claim denied can be disastrous. Fortunately, a denial does not necessarily signify the end of the road. In this article, we will guide you through what to do if the insurance company denies your TBI claim in Kansas or Missouri.
Step #1: Stay Calm and Avoid Responding Emotionally
It is understandable to feel angry after the insurance company denies your TBI claim. However, you should remain calm and avoid letting your emotions get the best of you. Do not yell or hurl insults at the adjuster, as that will not reverse the decision. Instead, focus on gathering the facts and building a strong response, as this will put you in the best position to challenge the denial effectively.
Step #2: Understand the Reason for the Denial
After an insurance company denies a claim, it will usually send a denial letter detailing the reason for the denial. If you haven’t received this letter, request that the insurance company send it. Review this denial letter to understand why your claim was denied. Some common reasons TBI claims are denied include;
- Disputes over liability
- Insufficient evidence
- Policy exclusions or limitations
- Pre-existing conditions
- Late reporting
- Failure to attend a medical examination arranged by the insurance company
If the reason for denial seems ambiguous or confusing, do not just accept it. You have the right to fight back against an unfair denial.
If the language used in the letter is unclear, present the letter to an attorney for help interpreting it.
Step #3: Gather Evidence
To challenge a denied TBI insurance claim, gathering strong evidence is crucial. Gather evidence, including;
- Medical records detailing the severity of the TBI and treatment
- Doctor’s notes explaining the case, severity, and impact of the injury
- Medical bills
- Evidence of how the injury has affected your daily life
- Eyewitness statements
- Expert testimony
- Accident scene photos
- Police reports
Step #4: Appeal the Decision
After understanding the reason(s) for the claim denial and gathering evidence to support your case, the next step is filing an appeal with the insurance company. Follow the insurance company’s appeal procedures, which may include filing specific documentation and meeting specific deadlines.
Step #5: Hire a Personal Injury Attorney
After your TBI claim is denied, one of the wisest things you can do is to involve a personal injury lawyer. A personal injury attorney with experience handling TBI claims in Kansas or Missouri can help you in several ways, including;
- Understanding why your claim was denied
- Gathering the right evidence
- Obtaining expert testimony
- Negotiating with the insurance company
- Preventing you from making costly mistakes
Contact Us for Legal Help
Do not handle a TBI claim denial alone. Contact our experienced brain injury counsel at Griggs Injury Law for professional legal help.
