Florida drivers often feel stuck after a denied insurance claim following a car wreck, especially when medical bills and car repairs continue to accumulate. However, a denial is not the end of the road. Florida law gives you several ways to challenge an insurer’s decision and push for a fair outcome.
Florida follows a no-fault system for personal injury protection (PIP). However, denials still occur due to late notice, missing documents, policy exclusions, or disputes over whether the crash caused the injury. Clear records, timely responses, and a structured appeal can change the result. An attorney with Fenstersheib Law Group, P.A. can help you appeal the insurer’s decision and work to obtain every dollar you deserve.
Insurers commonly cite late reporting, gaps in treatment, alleged pre-existing conditions, or policy exclusions as reasons for denying coverage. PIP rules require prompt treatment and proper coding, and adjusters will scrutinize imaging and therapy notes for consistency. A concise paper trail makes it harder to dismiss valid losses.
Florida law also regulates claim handling. Unfair claim settlement practices are prohibited, and carriers must provide specific reasons for denials that are tied to the policy language. Your lawyer can request that explanation in writing and compare it to the exact contract terms and medical records.
You must also ensure you don’t miss any deadlines. Policies establish short windows for disputing decisions, requesting appraisals, or seeking arbitration or mediation. Civil claims tied to contracts have longer time limits; however, waiting undermines leverage. A proactive attorney will move quickly while the evidence and memories stay fresh.
Start with the denial letter. Your legal representative will scrutinize that letter to identify every reason cited. They will then answer each reason with targeted proof – billing corrections, physician statements on the cause of your injury, shop estimates, and diagnostic images. Your attorney can also request that providers clarify coding issues and medical necessity in terms that the adjuster can easily understand.
Gathering a packet of the following critical documentation can help your legal professional present a more organized case. This documentation includes:
Florida’s Department of Financial Services offers mediation for many auto claims, and an appraisal may apply when the dispute concerns repair costs rather than coverage. Each path aims to resolve disagreements without resorting to litigation. Keep communications professional and complete; partial submissions invite another rejection.
If the carrier still refuses to pay, a formal civil remedy notice can precede a bad-faith claim under Florida law. That notice identifies the conduct and gives the insurer a chance to make a fair offer. A lawyer will outline whether that step fits your case and will map deadlines so you do not lose options.
Fenstersheib Law Group, P.A. focuses on steady communication and clear strategy from the first review through mediation or a lawsuit. Our firm will request the policy, audit the denial against your medical treatment records, and build a persuasive package that addresses Florida coverage rules and the insurer’s cited reasons. You will receive regular updates that explain what evidence will be requested and when responses are due.
Appeals succeed when the facts align with the specific policy terms. Tight documentation, prompt action, and a clean narrative of injury and repair costs put you in a position to reverse an insurance claim denial. Fenstersheib Law Group, P.A. will explain each option and will pursue the route that best fits the record and your goals. If you would like to schedule a free case evaluation, please use our online form or call 833-835-5354.
FREQUENTLY ASKED QUESTIONS (FAQ):
Why do insurance companies deny auto claims in Florida?
Insurers commonly deny claims due to late reporting, gaps in treatment, alleged pre-existing conditions, or policy exclusions. Florida’s no-fault system for PIP still sees denials for these reasons, as well as missing documents or disputes over whether the crash caused the injury.
What steps should I take to appeal a denied insurance claim in Florida?
Start by carefully reviewing your denial letter to understand the specific reasons cited. Then, gather critical documentation such as your denial letter, policy declarations, relevant policy pages, treating provider notes, imaging reports, itemized bills, and pay stubs to support wage loss. Your legal representative can then address each reason with targeted proof and potentially seek mediation or appraisal.
Can an attorney help me challenge a denied insurance claim?
Yes, an attorney can help you challenge a denied insurance claim by scrutinizing the denial letter, gathering evidence, building a persuasive package that addresses Florida coverage rules, and pursuing the best route for your case, whether it’s mediation or a lawsuit. They can also help ensure you meet all deadlines and understand your options.
The Lawyers at Fenstersheib Law Group, P.A. provide
personalized legal representation for personal injury cases.
FREE CONSULTATION 833-TellFLG • (954) 456-2488
