If you slip in a commercial space and sustain injuries, the property owner responsible for maintaining the area should cover the damage expenses under premise liability. However, in almost every personal injury case, the at-fault party’s insurance provider will exhaust every possibility of declining any claim that would compel them to pay compensation.
If you have filed a premise liability claim and the insurance company denied your case, you may still defend yourself and insist on compensation. Read more to learn how to turn your premises liability claim denial around and claim the settlement you deserve.
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What Is A Premises Liability Claim?
Premises liability addresses personal injury claims resulting from an injury on someone else’s property. This type of accident case demands the property owner’s financial responsibility if another individual suffers injuries due to their negligence.
Generally, you can prove the property owner’s liability under these circumstances:
- The at-fault party had the duty to maintain the property.
- They disregarded this responsibility.
- The breach caused your accident.
- You incur actual harm from the incident.
If you can justify these, you are entitled to file a premises liability claim and receive compensation for the accident’s damages.
What Damages Should I Include In My Premises Liability Settlement?
Typically, settlements from premises liability claims depend on the severity of the injuries and the actual damages caused by the accident. If you are pursuing a premises liability claim, you may consider the following damages to maximize your payout:
Economic Damages (financial losses) | Non-economic Damages (Non-monetary losses) |
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If you are dealing with a severe injury, it may be challenging for you to deal with a premise liability claim while pursuing your health recovery.
In such cases, property injury lawyers can help defend your case and maximize your payout by including all possible damages to cover, including economic and non-economic damages.
Why Is My Premise Liability Claim Denied?
The following are the most common premises liability claim denials:
Clear Assumption Of Risks
A clear assumption of risks is the most common premises liability claim denial. That means that the insurance provider noted that the owner provided clear warnings of the defects or dangers of the property. This may demonstrate that you had a clear assumption of risks.
When proving this specific argument, the at-fault party’s insurance provider must prove that:
- You were aware of the existing hazards.
- You understood the risks of the threats.
- You voluntarily exposed yourself to the dangers on the property despite understanding the risks.
However, you may still have a chance to refute the claim denial if the following circumstances were observed during the incident:
- The location of the sign was challenging to see.
- The warning sign had unreadable text, making it unclear to visitors.
- The warning sign was too small to be seen.
A premises liability attorney will investigate your incident and determine if these instances increased the dangers on the property, leading to your injuries.
Pre-Existing Medical Condition
Your medical record is an important document that showcases the doctor’s diagnosis, which verifies your injuries. In most cases, the insurance company will ask for your medical files to confirm the severity of your injuries.
If you have an existing medical condition similar to the injury you incurred from the accident, they may insist on the following:
- Your injury was not as severe as you claimed.
- Your damage was not caused by the accident.
- Your injury only worsened due to the incident.
To avoid these challenges, you must do the following:
- Avoid sharing any pre-existing medical conditions that are unrelated to the accident.
- Refrain from signing a blank release form.
- Consult with property injury lawyers.
Your premises liability attorney will help you if the insurance provider demands unnecessary medical records unrelated to your accident. Remember that you have the right to decline any requests, especially if they are irrelevant to your case.
Medical Treatment Gaps
After the doctor’s diagnosis, you will likely need to adhere to treatments or rehabilitation to heal the injuries you incurred in the accident. However, this may be a loophole if you neglect these treatments. The insurance provider may argue that your injuries aren’t severe enough to reduce the compensation value.
This is why you must follow the tips below to refrain from having gaps in your medical treatment:
- Consult the right doctor with expertise in the injuries you have.
- Seek medical attention as soon as you incur bodily damages from the accident.
- Follow your doctor’s recommendations and orders.
- Attend your treatment or rehabilitation religiously.
Comparative Negligence
The insurance company may assert that you are partially responsible for the accident to deny your claim or reduce the settlement amount. With pure comparative negligence, you may still be entitled to receive compensation. However, this will be reduced based on how much you are responsible for the actual damages of the incident.
For instance, let’s say you are 30% liable for your slip-and-fall accident in a grocery store. The insurance provider will then pay 70% of the compensation.
If you are partially at fault, your premises liability attorney can assist in examining the nature of your case and providing you with legal options.
How To Appeal Your Premise Liability Claim Denial
Step 1: Understand Why Your Premises Liability Claim Is Denied
Sometimes, your premise liability claim may be denied, especially if there are loopholes in your case. To appeal the claim denial, you should understand why your case was dismissed in the first place. By doing this, you may develop strategies that will make your claim solid and difficult to refute.
Step 2: Consult A Premises Liability Attorney
Filing a premises liability case may be complicated, especially if you face hurdles that hinder you from receiving maximum compensation. Property injury lawyers can assist in refuting the insurance provider’s arguments and defending your claim.
You may think you will likely save money if you avoid seeking help from a premises liability attorney. However, this is usually not the case. A legal expert can help you with the following to maximize your chances of claiming a fair settlement offer.
- Investigate the facts of the accident.
- Gather the necessary evidence to support your claim.
- Calculate the total damages.
- Communicate with the insurance provider.
- Refute any arguments that may reduce your compensation value.
- Defend your case.
- Proceed to trial if necessary.
A premises liability attorney will always search for ways for you to receive fair compensation. This is why it is best to seek legal advice, especially if you are far from proving your case.
Step 3: Gather More Evidence
It is likely that you couldn’t collect evidence at the accident scene due to the physical pain of your injuries. Because of this, you may overlook some evidence that makes your case vulnerable to loopholes.
As you understand the reason for the denial, you have greater chances of gathering evidence to help assert your claim, especially if you have a premises liability attorney. They can reassess the nature of your accident and check for other evidence you may have missed.
Step 4: Prepare & Submit An Appeal Letter
You may now prepare your appeal letter if you have gathered enough evidence to back your case. When doing so, you must include the necessary information that refutes the insurance company’s denial, such as:
- Your information, such as your name and contact details.
- The at-fault party’s contact details.
- The reason why you are sending the letter.
- The facts that support your appeal
- The description of your injuries and premise liability claim.
- The specific settlement amount you are demanding.
Your premises liability attorney will assist in drafting your appeal letter. After preparing and finalizing this, you may submit it to the at-fault’s insurance provider. Cooperate with your attorney to know the next steps of the legal process.
Can I File A Lawsuit If My Premises Liability Claim Is Denied?
If the insurance company still denies your claim, your lawyer may advise you to take your case to trial. While this may seem overwhelming, your premises liability attorney will stay by your side and defend your case all the way through.
The lawsuit may take some time to resolve. Usually, it is easier to settle your claim out of court. However, if you need to move your case to trial, it is best to have a legal expert who can guide you through the legal process of your premises liability case.
How Can A Premises Liability Attorney Help In My Claim Denial?
The best way to avoid having your claim denied is to hire a personal injury lawyer to handle your case smoothly. However, if you fail to consult an attorney and your case gets dismissed, you may still pursue compensation for the damages of your accident.
Let’s say the insurance provider dismisses your case since you have treatment gaps. Personal injury lawyers can investigate your accident and gather evidence to prove the cause of your injury. This is why it is best to seek legal help when filing a premise liability claim.