In 2023, insurance companies spent approximately $259 million settling claims [1]. Though the average bodily injury insurance claim in 2022 was $24,211, it does not mean everyone who submits a claim will have their medical bills and other expenses covered.
A closed insurance claim can be a significant headache for victims, especially as many insurance companies may refuse to give the claim a second look.
Reopening an insurance claim can be challenging, so it is crucial for those whose claims have been closed to contact a lawyer immediately for help.
What Does it Mean for a Claim to Be Closed?
A closed claim is typically the end of the claims process, where the insurance company has concluded negotiations with the accident victim and provided all the compensation they agreed to.
Sometimes, they will deny the claim entirely, following insurance policies, and not provide any compensation. This denial may be due to factors like a lack of evidence, the victim failing to follow proper procedures, or misrepresenting the severity of the victim’s injuries.
Reasons Why Claims Get Closed
There are several reasons an insurance claim is closed. The first is that the injured victim has accepted the insurance settlement offer and signed a release stating they will not seek a higher settlement.
The company may have denied the insurance claim entirely due to factors like the victim being the at-fault party or having insubstantial evidence to prove that the other driver was responsible.
Lastly, the statute of limitations may have expired during settlement negotiations, meaning the insurance company is no longer responsible for honoring claims. You must file promptly and work with a law firm that can help expedite the process so you do not miss any critical deadlines.
Circumstances When Reopening Might Be Possible
In specific instances, accident victims may be able to have a claim reopened. A car accident attorney can assist you in determining your legal rights to reopen a claim based on changing circumstances and help you negotiate with the insurance company.
Unforeseen Complications or Worsening Injuries
If the victim suffered injuries that were not immediately apparent or complications with their healing process after insurance adjusters determined the claim was over, they may be able to seek compensation to cover these unforeseen complications.
For example, if the victim developed chronic pain from a slipped disc that was not initially documented, and it can be proven that it was a direct result of the accident, then this may justify a second look at the claim.
Evidence of Insurance Bad Faith
Insurance companies must act in good faith, which means they should clearly and accurately represent the relevant insurance policy, consistently communicate with victims, and promptly settle claims after a thorough investigation.
One common problem is insurance companies stalling for additional time until the statute of limitations expires, at which point they are no longer responsible for honoring their obligations. They may do this by repeatedly asking for more information beyond what is necessary to investigate.
If the insurance company acted in bad faith, such as failing to disclose important policy information, offering an unreasonably low settlement, or denying a claim without proper investigation, it may be possible to reopen your claim. This process requires a full understanding of the policy and the law, which is where a lawyer can be helpful.
Clerical Errors or Mistakes
An insurance claim is a complex document that involves multiple parties. When one of them makes a mistake, such as an insurance adjuster failing to document part of their investigation or the wrong date being placed on the claim, you may be able to request that a claim be reopened.
It must be proven that these mistakes directly impacted your offer. For example, if the adjuster put the wrong date, which meant the claim was prematurely considered expired, this could be a valid reason to refute the original offer.
State-Specific Laws and Regulations
Some states have policyholder-friendly laws mandating that an insurance claim be reopened if specific circumstances are met. These conditions may include factors such as newly discovered evidence or fraud in the original settlement process. During our free consultation, we’ll assess the specific laws in your jurisdiction that may allow you to renegotiate a settlement agreement.
Challenges and Limitations of Reopening Claims
When you work with our law firm, an experienced car accident attorney will explore your legal options for reopening a closed insurance claim and inform you of the potential challenges you’ll face.
Signed Release and Settlement Agreements
Once you accept a settlement offer, you will sign a settlement release, which asserts that you will not seek additional compensation. This signed release prevents the claim from being reopened except in specific circumstances, like being pressured to accept a lowball offer, signs of fraud, or a mutual mistake.
Statute of Limitations
The state’s statute of limitations is often the hardest challenge to overcome, as these rules have few exceptions. These limits demonstrate the importance of promptly speaking to a lawyer and filing a claim. Quick action provides your attorney more time to negotiate with the insurance company.
Insurance Company Resistance
Insurance companies are reluctant to reopen claims, especially if the victim has already approved the settlement amount. Doing so has costs, including additional time and money spent on negotiations and setting a precedent that their decisions are not final.
As such, it often requires compelling evidence, like significantly higher medical expenses after a complication or further investigation into the at-fault driver. A Chicago personal injury attorney will likely be necessary to convince the insurance company.
Steps to Take if You Want to Reopen a Claim
Getting a second look at a claim can be challenging, especially if you have already signed an agreement. However, an attorney can offer you options and ensure that your rights are protected throughout the process.
If you want to take legal action and reopen a claim, you will need to gather documentation, work with an attorney, and contact the insurance company about your decision.
Gather Evidence and Documentation
Before your initial consultation with our law firm, gather all documentation showing the insurance company acted in bad faith or that you have a compelling reason to reopen the claim.
This evidence can include medical records related to your injuries, medical bills, the settlement offer, and any communication you have had with the insurance provider.
Consult with an Attorney
You’ll then contact a law firm, where an attorney can consider the viability of reopening a claim and help you navigate the legal process. The legal team will review your case and identify your options in accordance with state law and policies.
Communicate with the Insurance Company
Your attorney will help you contact the insurance company and present your case for review of the settlement offer. This step can include additional evidence that may not have been available at the time of the claim.
Why You Need a Personal Injury Attorney
A personal injury lawyer is crucial in reopening a claim, as we have the skills and experience necessary to navigate this complex process.
Assessing Your Case and Options
An attorney can review the specifics of your case and determine whether it is possible to reopen the claim and what the long-term implications of this may be.
Negotiating with the Insurance Company
We will push for maximum compensation from the company by presenting compelling evidence, such as demonstrating how your injuries have worsened since the initial settlement in ways that could not have been foreseen when you signed the agreement.
Representing You in Legal Proceedings
Sometimes, if the company refuses to act in good faith, a lawsuit is necessary. In this case, we will represent you in legal proceedings, presenting your case to a jury so that you have a better chance of getting fair compensation.
Call an Experienced Lawyer to Help You
While it is not always possible to contest a low settlement or denied claim, especially if an agreement was already signed, Rosenfeld Injury Lawyers will explore your options and ensure that you have the best chance of receiving compensation that covers your needs. We have assisted thousands of victims nationwide in getting the best settlement possible.
To schedule your free consultation, call us 24/7 at (888) 424-5757 or fill out our contact form.
References: [1] Insurance Information Institute