5 Top Reasons Why Your Insurance Claim Might Be Rejected


One of the biggest worries when filing an insurance claim is that your claim will be rejected or denied by the insurance company. Even if you have all the documentation, photos, and eyewitnesses necessary to prove that your injuries are real and severe, sometimes you can get turned down by an insurance company either as part of their pre-screening processes or because they don’t want to pay for the kind of treatment you need. This can leave you feeling frustrated and without the resources to get the care that you need to recover from your injuries. But it doesn’t have to be this way!

1) Not filing a claim

Just because you haven’t been in an accident doesn’t mean that filing a claim is a bad idea. Most of us have probably had experiences with breakdowns, freak accidents, or simple mistakes that we have to pay for—and insurance can help make sure these costs don’t eat away at your budget. Check with your agent about any coverage gaps you might be leaving open; there may be ways to fill them with relatively affordable insurance policies.

2) Filing an incomplete claim

Before filing an insurance claim, take stock of all your property and think about what’s most important to you. For example, if you’re getting married in a year and have no desire to replace your photo albums, then make sure you emphasize that when filing your claim with your insurance company.

It may be worth taking pictures of all your belongings just in case they get destroyed or stolen; it might seem like overkill at first but it can help you out in a pinch down the road.

3) Thinking you’re covered for everything

If you have health insurance that covers prescription drugs, you might be in for a surprise. Most people assume their prescriptions are covered but they aren’t—at least not by your insurance company. Instead, you’re covered by third-party payers. A third-party payer is any entity that pays for healthcare expenses on behalf of others.

4) Ignoring policy limits

While it’s important to file a claim if you need to make repairs or replace damaged or stolen items, not doing so can be costly. If your policy has a limit on how much coverage it provides, filing a claim could leave you underinsured. To ensure that you get paid for all of your losses, don’t file an insurance claim if your losses are above and beyond what your policy limit is.


5) Trying to be sneaky

Some insurance claims are rejected because people try to cheat their way out of paying for an incident. If you’re in an accident, don’t lie about what happened. It won’t pay off, and it could have repercussions down the road if you ever need your insurer to back you up. Plus, nobody wants a scammer on their side! So be honest from day one—that way you can avoid rejection later on.