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Key Takeaways
- Case denials and challenges are common, but do not mean your claim is over.
- Common reasons for denial include lack of evidence, procedural errors, disputes over fault, and insufficient medical documentation.
- After a denial, you can strengthen your claim by reviewing the denial notice, gathering more documentation, and contacting an attorney.
- The appeals process may involve internal reviews, formal appeals, and, in some cases, litigation in court.
- Working with NST Law provides you with experienced legal guidance to navigate complex appeals and effectively push back against insurers.
It is the unfortunate reality that cases get denied or challenged from time to time. This can be an extremely frustrating experience for you and your family, especially when dealing with injuries and property damage.
However, denial is not the end of your case, and there are steps you can take. NST Law is a trusted law firm that supports clients through these situations. To learn more, call our office today at 800-529-4004.
Why a Case May Be Denied or Challenged
There are numerous reasons why a case may be denied or challenged; however, the most common of these include the following:
- Lack of evidence – Insurance companies often dispute claims due to documentation gaps.
- Procedural errors – Filing mistakes or missed deadlines can trigger denials.
- Disputes from insurance companies – Insurers or other parties may challenge who is at fault for your injuries, even claiming you are responsible for the incident.
- Medical documentation issues – Your claim may be denied if insufficient medical documentation serves as evidence.
While denials and challenges to your case can be stress-inducing, they do not necessarily mean the claim is invalid. A denial reflects the carrier’s position—not a final judgment on your rights.
What To Do After a Denial or Challenge of Your Claim
In the aftermath of a case denial, you can take proactive steps to strengthen your claim before filing an appeal.
- Review denial notice – It is essential to evaluate the reasons for your case’s denial and any stated deadlines for an appeal.
- Gather documents – If insufficient evidence contributed to the denial, take time to collect medical records, witness statements, or other proof to strengthen an appeal.
- Contact an attorney – NST Law plays a vital role in helping clients navigate the appeal process and improve outcomes.
It is crucial to act quickly to preserve rights and deadlines. Get in touch with our legal team today to learn more.
Understanding the Appeal and Challenge Process
Knowing what to expect with the claims appeal process allows you to better navigate it and overcome any barriers along the way.
- Internal Review: The first step is typically an internal review, where the insurer or organization reexamines the denial. This allows you to submit additional information, clarify errors, and request a fresh claim evaluation.
- Filing a Formal Appeal: If the denial is upheld, you may need to file a formal appeal. This stage often has strict deadlines and requires supporting documentation, such as medical records, expert opinions, or financial evidence. Missing a deadline or failing to provide the correct information can jeopardize your claim.
- Potential Litigation: Some cases may escalate to litigation when internal and formal appeals are unsuccessful. This means taking legal action in court to pursue the benefits or compensation you are entitled to.
The precise process varies—insurance appeals (including some employer plans) follow internal review rules, while disputed injury claims may move from negotiation to a lawsuit if the carrier won’t be reasonable.
This process can be complex, and having legal guidance is critical to your claim’s success.
Why People Choose NST Law for Denied or Challenged Cases
Our firm has over 35 years of experience handling personal injury cases alongside extensive resources and a commitment to our clients’ success.
With billions won, a 175-person team, and a trial-ready approach to every case, NST Law combines scale and personalization. We are available 24/7 to take your call and can meet you at home or in the hospital—wherever is most convenient.
NST Law levels the playing field against powerful insurers or organizations with our strategic approach to negotiations. We understand how these entities operate to minimize payout and will push back against unfair settlement offers.
Hear From Our Satisfied Clients
We are proud to attest to the dedication of our attorneys, but do not just take our word for it. Read our testimonials below to learn about the experiences of past clients with us.
“I have NEVER had anything less than an amazing experience with NST. From beginning to end, the process is always laid out in detail and they kept me updated throughout the experience. I highly recommend using their services if you find yourself in any vehicle collisions.”
“I was not expecting the amount I received. Thank you guys so much. High five to you all. You’re the best!!!! They took my case when no one else would. Can you say happy tears. Way to go NST!!!!”
Speak With a Personal Injury Lawyer at NST Law Today
You and your family are in good hands when you choose to partner with NST Law. We are passionate about our clients and the communities we serve. Our team can get started on your case immediately, building a compelling appeal and fighting back against false allegations from insurers. There are no upfront costs when you work with our team. Contact our law office today to schedule a free consultation.
Common Questions About Denied or Challenged Cases
Does Working With a Lawyer Improve My Chances of Overturning a Denial?
By hiring an attorney, you are securing a legal professional with insight into how insurers work and a unique skillset to navigate the appeals process. The knowledge and experience that they provide can significantly improve your chances of overturning a denial.
What Types of Evidence Are Essential for an Appeal?
Strong evidence includes medical records, expert evaluations, witness statements, and any documents that directly support your claim and address the reason for denial.
What if My Appeal Is Also Denied?
If your appeal is denied, you may still have the option to escalate the matter to a higher-level review or pursue legal action in court.
What Is the Timeline for a Denied Case To Be Resolved After Filing an Appeal?
The timeline can vary widely, from a few weeks to several months or longer, depending on the complexity of the case and whether litigation becomes necessary.
