How to Handle a Denied PIP Claim in Washington
July 16, 2020 – Matt Albrecht
Many motorists have insurance coverage that goes well beyond simple liability protection. One of the most important types of auto coverage is Personal Injury Protection (PIP coverage). As explained by the Washington State Office of the Insurance Commissioner, Personal Injury Protection is an add-on policy that provides no-fault medical and wage loss benefits to the policyholder.
Unfortunately, in some cases, PIP claims are improperly denied. An insurance company may make it difficult for a policyholder to get access to the full and fair benefits that they rightfully paid for. In this article, our Spokane insurance lawyers provide an overview of three key steps that you should take if your PIP claim is denied in Washington.
1. Review and Understand the Denial Letter
As was mentioned, PIP coverage is designed to provide no-fault medical and wage loss benefits. In other words, a PIP claim does not require a policyholder to prove the other party was at fault for the accident. Still, there are many reasons why a Personal Injury Protection claim might be denied. Some notable examples include:
- Allegations that the injury is not related to the accident;
- A determination that the medical treatment is not reasonable or necessary;
- Disputes over the applicability of a policy exclusion; and
- Assertions that premiums went unpaid or that the policyholder missed a deadline.
In Washington, PIP policyholders should receive a written denial letter from their insurer that explains the basic reasoning behind the company’s decision. To effectively challenge the denial, you must know the reason for denial.
2. Gather and Organize Relevant Information
Once you have a basic understanding of why your PIP claim was rejected, you should gather and organize all documents, records, and evidence relevant to your case. Ultimately, you must address the insurer’s stated reasoning directly with relevant evidence or a legal argument. Among other things, this will likely include the accident report, policy history, and your medical records. Many disputed PIP claims are centered on disputes pertaining to medical treatment or medical records.
3. Call an Insurance Lawyer: Prepare an Appeal
You should be very careful when dealing with an insurance company—even if it is your own insurer. If you believe that your Personal Injury Protection claim was wrongfully denied, call an experienced Spokane insurance appeals lawyer for help. Your lawyer will be able to review your case and determine what steps you need to bring an effective appeal under the terms of your policy. PIP claims typically have very strict deadlines. You should act quickly after receiving a written denial letter.
Was Your Personal Injury Protection Claim Denied in Eastern Washington?
We can help. At Albrecht Law PLLC, our Washington insurance claims lawyers are strong, focused advocates for clients. If your Personal Injury Protection (PIP) claim was denied, professional support is just a phone call away. Contact our legal team for a free, no-obligation initial consultation by calling (509) 495-1246. We handle insurance appeals throughout the region, including in Spokane, Spokane Valley, Airway Heights, and Country Homes.
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