| Insurance companies will send you a coverage denial | | | | need to understand the declarations page, the |
| letter when they believe their investigation is | | | | insuring agreement, the definitions, the exclusions, |
| complete and there are no grounds for granting | | | | and any applicable endorsements. To learn how to |
| coverage. | | | | accurately read your policy visit |
| There are many reasons why an auto claim is denied. | | | | Note, there are other reasons why insurance |
| The most common reasons for denials are: | | | | companies deny coverage. The accident happened |
| non-payment of premium, the coverage is specifically | | | | before the policy coverage period was active. The |
| excluded form the policy. The more severereasons | | | | accident happened outside the coverage geographical |
| are misrepresentation of the insurance application and | | | | area, the driver was specifically excluded from the |
| fraud. If you misrepresent anything in the insurance | | | | policy, there was prior damage to your car, you do |
| application, then it would excuse the insurance | | | | not have the specific coverage you are seeking (a |
| company from performing as agreed under the | | | | tree fell in you car and you do not have |
| terms of the policy. Most courts do not side with | | | | comprehensive coverage in your car). Other |
| insureds when there are misrepresentations of | | | | important reasons for exclusions of coverage |
| material facts. Make sure that you answer truthfully | | | | because you did not mitigated your loss, and/or did |
| when you are filling out the insurance application. If | | | | not report the claim within a reasonable time. |
| you do not know the exact answer, tell the | | | | Remember that you have the burden of proving |
| insurance agent that you will answer once you have | | | | your loss. However, the insurance company has the |
| certainty about your answer, do not guess, it can | | | | burden of proof when they deny a claim. In other |
| cost you a lot of headaches. | | | | words, the insurance company must prove to you |
| The worst thing that can happen is that you end up | | | | that the coverage is excluded, there was fraud or |
| with a coverage denial because you said or wrote | | | | misrepresentation, and/or all the other reasonsnoted |
| something that can be construed as | | | | above. Make sure they put everything in writing so |
| misrepresentation. | | | | you know exactly why there is a coverage denial. If |
| A coverage denial based on fraud usually occurs | | | | you ever go to court, this will help you because |
| because the insured tries to inflate the value of the | | | | courts interpret exclusions of coverage very |
| claim. They claim that their car stereo was equipped | | | | narrowly and against the drafter of the policy (the |
| with DVD player when in reality it only had a CD | | | | insurance company). |
| player. Trying to inflate the claim will leave you with | | | | By requesting all documents of the investigation, the |
| no coverage at all, even if there is damage to a third | | | | coverage denial letter, and a certified copy of the |
| party. So never misrepresent your damages, because | | | | policy, you will be setting up a case to protect |
| if you get caught, the insurance company will give | | | | yourself and seek a declaratory judgment by a court |
| you a coverage denial and a court of law would side | | | | to grant you the coverage that you paid for. Review |
| the insurer. | | | | all these documents and make sure they are crystal |
| The most common coverage denial, however, is for | | | | clear. Most courts will side with the insured unless the |
| items specifically excluded in the policy. You need to | | | | insurer did everything by the book. Make sure they |
| be able to navigate and read the insurance policy to | | | | did. |
| learn what is covered and what is not covered. You | | | | |