What to do when an insurer denies your injury claim after a minor accident (Missouri)

Quick answer: Review the denial, gather and organize all evidence, submit an internal appeal to the insurer, consider sending a formal demand, file a complaint with the Missouri Department of Commerce & Insurance if needed, and prepare to pursue mediation, arbitration, or a court case if the insurer won’t reverse the denial. Deadlines and required steps can come from both your policy and Missouri law, so act promptly.

Detailed answer — step-by-step

1. Read the denial carefully

Insurers must send a written denial explaining why they rejected the claim. Note the reason(s) they list (coverage exclusion, lack of medical proof, late notice, preexisting condition, statement inconsistencies, etc.). The denial letter often includes appeal instructions and deadlines in your policy — follow those exactly.

2. Confirm coverage, notice, and deadlines

Check your policy for who is covered, the scope of coverage, notice requirements, and any internal-appeal or proof-of-loss deadlines. Also be aware of Missouri’s civil deadlines for suing over personal injuries. In most personal-injury cases in Missouri, the statute of limitations is five years for actions for damages for injuries to the person, which is set out in the Missouri Revised Statutes. See Missouri Revised Statutes, Chapter 516, section 516.120 (civil actions for injuries to the person). For the official text, visit the Missouri Revisor: RSMo § 516.120.

3. Gather and organize evidence

Build a clear claim packet. Include:

• Medical records and billing statements showing treatment and diagnosis.
• Accident documentation: police report, photos of the scene and vehicles, contact info for witnesses.
• Proof of lost wages or diminished earning capacity, if any.
• Copies of all communications with the insurer (letters, emails, notes from phone calls with dates and names).

4. Submit an internal appeal or demand for reconsideration

Most insurers have an internal appeal/reconsideration process. In the appeal:

• Reference the denial date and reason.
• Attach the new or missing evidence that addresses the insurer’s stated reason for denial.
• Be concise: state what relief you seek (payment, reconsideration) and why the denial is incorrect.

Send the appeal via a verifiable method (certified mail with return receipt, or email where you can document delivery). Keep a complete copy of everything you send.

5. Use a demand letter if the insurer is unresponsive or still denies

If the internal appeal fails or stalls, send a formal demand letter that summarizes the claim, documents damages, explains legal theory (liability and causation), and states the amount you seek. This letter often precedes mediation or litigation.

6. File a complaint with the Missouri Department of Commerce & Insurance

If you believe the insurer acted unfairly (bad faith, unreasonable delay, failure to investigate), you can file a consumer complaint with the Missouri Department of Commerce & Insurance. The Department can investigate and may compel corrective action in some cases. For consumer complaint filing information, see: Missouri Department of Commerce & Insurance — File a Complaint.

7. Consider alternative dispute resolution

Many disputes are resolved in mediation or arbitration. Check your policy or the insurer’s offer—sometimes arbitration is required by contract, but binding arbitration can limit future court remedies. Mediation is voluntary and often helps settle smaller claims faster and at lower cost.

8. Prepare for litigation if necessary

If negotiations fail, you may file a civil suit. Make sure you file within the relevant Missouri statute of limitations and meet any pre-suit requirements in your policy. Civil suits involve discovery, witness testimony, and potentially a trial. For personal-injury actions, consult RSMo § 516.120 and related civil procedure rules.

9. When to talk with an attorney

Consult an attorney if:

• Your injuries required medical treatment beyond basic first aid or you have ongoing symptoms.
• The insurer claims a coverage exclusion you don’t understand or disputes liability.
• The claim involves significant medical bills, wage loss, or permanent impairment.
• The insurer denies your claim and you are considering a lawsuit or arbitration.

An attorney can evaluate liability, damages, policy language, and advise whether filing suit or negotiating is the best path.

Common reasons insurers deny minor-accident injury claims

• Late notice of the accident to the insurer.
• Insufficient medical evidence tying your injury to the accident (causation).
• Discrepancies in statements or witness accounts.
• Policy exclusions or lack of coverage.
• Preexisting condition where the insurer argues the accident did not materially worsen the condition.

Missouri law and insurer duties

Missouri regulates insurance practices through statute and administrative rules (see Chapter 375 of the Missouri Revised Statutes for insurance laws and regulations). The Missouri Department of Commerce & Insurance also enforces consumer protections and handles complaints. For the chapter index, see: RSMo Chapter 375 — Insurance.

Helpful Hints

• Act fast: collect evidence and preserve records immediately after the accident.
• Follow your insurer’s notice and appeal procedures to avoid procedural denials.
• Get prompt medical care and ensure your treating provider documents that your injuries are related to the accident.
• Keep a treatment diary: record symptoms, how the injury affects daily life, and dates of appointments.
• Send written communications and use trackable delivery methods for important documents.
• Before signing anything from the insurer, read it carefully — do not sign away rights without understanding consequences.
• If the insurer asks for an independent medical exam (IME), understand your rights and the scope of the exam; consult an attorney if unsure.
• File a complaint with the Missouri Department of Commerce & Insurance if you suspect unfair claim handling: insurance.mo.gov — complaints.

Disclaimer: This article explains general legal concepts under Missouri law and describes common steps people take after an insurance denial. It is not legal advice, and it does not create an attorney–client relationship. For advice about your specific situation, consult a licensed Missouri attorney.