How to appeal a car insurance claim denial

If you or your passengers have been injured in an accident, or your vehicle has been damaged in a crash or non-collision event, you must file an auto insurance claim to receive financial restitution. But in some cases, your claim may be denied. This can occur for many reasons, from sloppy record-keeping on your part to errors on the insurer’s part.

If your claim is denied, you can appeal the decision. But first, you’ll need to find out why the insurer denied your claim, then gather supporting evidence and submit a letter of appeal to that carrier. You may also need to seek legal advice or hire a public adjuster to assist with your appeal.

Learn more about reasons for car insurance claim denials, what to expect in a claim denial letter, how to appeal a car insurance claim denial, and what to do if your appeal is denied.

Key highlights

• Car insurance claims may be rejected for various reasons, such as unpaid premiums, inaccuracies in the application or lack of appropriate coverage.
• When faced with a denial, it's crucial to examine the denial letter, collect pertinent documents like police reports and witness accounts, and familiarize yourself with your policy to build a solid appeal.
• If the appeal doesn’t succeed, consider alternatives like mediation, arbitration or other legal action, and seek guidance from a lawyer or public adjuster who can help manage the process.

Why was my car insurance claim denied?

If you’ve been injured in an accident or suffered damage to your car, it’s natural to assume your car insurance company (or the other driver’s, depending on who’s at fault) will cover the associated costs. But that’s not always true.

“Reasons for car insurance claim denial include failure to pay your premium, failure to accurately fill out the insurance application or, in some cases, because you were not the one driving the vehicle involved,” said Mitch Chubb, founding attorney at Chubb Law Firm in Lake Mary, Florida.

Additionally, if your auto insurance claim is insufficiently documented or not filed promptly, your insurer could refuse it, he said.

“In a non-accident situation, events like acts of nature, including a tree branch falling on your car, could also lead to claim denial. These incidents will only be covered if you have the appropriate coverage on your policy,” Chubb said.

Your claim may also be rejected when dealing with another party’s insurance company if that carrier doesn’t investigate thoroughly.

“Insurers will frequently look at a police report or take a statement from their [policyholder] to determine their position on liability. In auto accidents, this can sometimes lead to an unfair determination of fault because the police officer rarely witnesses an accident and sometimes only takes a statement from one party,” said Michael McCready, founder/managing partner at McCready Law Firm in Chicago.

What is a claim denial letter?

If an insurer opts not to approve your claim, it will notify you in writing, typically by mail and/or email. But don’t expect a detailed explanation.

“Very often, there may be no explanation or just a basic one-sentence explanation for why the claim is being denied,” says Tara Tighe Umbrino, managing attorney for TLT Legal Services in Woodbridge, Virginia. “Most companies will put this in writing so that there is a record of the communication.”

It is important to review the denial letter as soon as possible to determine the appeal deadline and consider your options. If any part of the letter is unclear, contact the insurer.

How do I appeal a car insurance claim denial?

If your claim is denied, that doesn’t mean you’re out of options. You have the right to challenge the denial and pursue an appeal of the decision. Here’s what you need to do.

Gather important documents

You will need evidence to back up your appeal, including the following documentation:

• A copy of the denial letter
• Police/accident report(s)
• Photos and/or video footage of the event and damage
• Statements from witnesses
• Repair estimates and receipts
• Medical reports/records in any cases involving personal injury

“Any document you believe will help prove that the denial is improper should be included in your appeal,” Chubb said.

Review your car insurance policy

Understanding car insurance policy coverages and requirements is crucial if you want your appeal to succeed.

“Carefully read your policy to understand what’s covered and the coverage limits as well as what’s excluded, along with any endorsements,” said Dennis Shirshikov, a professor of finance and economics at City University of New York/Queens College. “Focus on the sections related to your claim, and look for any ambiguities that could be in your favor.”

Policies often contain complex legal language. Consult an attorney if you feel any policy wording is confusing or unclear.

Contact your insurance company

After gathering your documents and examining your policy, contact the car insurance company and ask why your claim was denied.

“The best approach is to start with a phone call to get immediate clarity on why you were denied. Follow this up with a formal email to have everything in writing,” Shirshikov said. “During these conversations, inquire about specifics. Ask: What clause in your policy led to the denial? Was there missing documentation? Maintain a polite but assertive tone.”

Remember to keep a written record of your communication with the company.

If you remain unsatisfied with the carrier’s answers or response, indicate that you plan to appeal the decision. Ask how this process works and what the requirements and deadlines are.

“Each insurance company will have its own process for appealing a claim denial,” Umbrino said. “If you are making a claim against your own policy, that process is likely to be different than if you are making a claim against someone for being at fault.”

Submit an appeal letter

Curious about how to write a car insurance appeal letter? The experts we consulted recommend these tips:

• Use clear, organized language that directly addresses the points raised in the denial letter.
• Include your policy number, the denial reference number, and a detailed explanation of why you believe the claim was wrongfully denied.
• Include evidence or documents supporting your position that the denial was improper.
• Avoid including anything that could strengthen the carrier’s case, such as inflammatory language.
• Maintain a professional tone.
• Review, edit,, and spell-check the document.
• Send the letter to the insurer via certified mail and email if possible.
• Follow up with the insurer to confirm receipt and inquire about the timeline for a response.

Consider hiring a lawyer or public adjuster

To improve your chances of winning an appeal, you may want to hire an attorney who specializes in insurance. Alternatively, you can hire a public adjuster. These insurance professionals work for you, not a carrier, and can help navigate the appeal process from damage estimates to settlement negotiations.

“If your initial appeal is unsuccessful or the claim is large and complex, hiring a lawyer or a public adjuster may be a smart move,” Shirshikov said. “Public adjusters can work on your behalf to negotiate with the insurance company, and they typically work on a contingency fee – meaning they only get paid if you win your appeal. Legal representation, on the other hand, may be necessary if you are preparing to go to court.”

Hiring a lawyer for car insurance claim denial assistance is your most expensive option.

“And be aware that even personal injury lawyers who only charge a contingency fee rarely like to take cases where there is a dispute about liability,” McCready said.

If your car insurance appeal is denied, you can further pursue your appeal via three primary options: mediation, arbitration or filing a lawsuit. Each of these choices typically involves getting a lawyer to represent you.

“With mediation, a neutral third party helps facilitate a compromise between you and the insurer. This can be less formal and less costly than litigation,” Shirshikov said.

Arbitration, meanwhile, functions more like a court proceeding, “where each side presents their case and the arbitrator makes a binding decision,” Chubb said.

Arbitration is more binding than mediation but still avoids the expense of a full court case. In arbitration, the parties can agree upon their own rules and select their arbitrator, who will act as judge and jury. In some states or under specific insurance contracts, arbitration is mandatory.

Finally, you can file a lawsuit against the carrier if all else fails.

“This starts by filing initiation documents in the proper court,” Umbrino said. “Depending on how much you sue for, you may be able to handle this in small claims court, which is usually faster and cheaper and has more relaxed rules of evidence.”

Expert’s advice: How to appeal a car insurance claim denial

If you’re appealing a car insurance claim denial, experts say it’s crucial to be thorough, persistent and informed.

“Focus on gathering the best possible evidence to support your case. If the claim is denied for a technicality, explore every possible avenue within your policy that could work in your favor,” Shirshikov said. “Always keep records of your communications, and be prepared to escalate if necessary.”

It may also be in your interest to hire a lawyer experienced in auto insurance appeals to handle your case.

“Insurance companies have attorneys on staff, and this is what they do all day, every day,” Umbrino said. “Without an attorney, you will likely be at a disadvantage if you get to the point of needing to file a lawsuit.”

Chubb agreed.

“I would seek out an attorney who works on a contingency fee basis to handle the matter on my behalf,” he said.