Overview of the appeal process after an insurance denial

If an insurer denies your injury claim after a minor accident in New Jersey, the typical path involves several steps you can take before (and sometimes instead of) filing a lawsuit. These steps preserve your rights, create a clear record, and may lead to a resolution without court.

1) Read the denial carefully and note deadlines

The denial letter should state the reason(s) for denial. Note any appeal deadlines or time limits. Even if none are listed, you must act quickly because filing a lawsuit later can be barred by New Jersey’s statute of limitations for personal injury claims (typically two years). For help finding statutory deadlines and filing options, see the New Jersey Courts self-help pages: https://www.njcourts.gov/selfhelp/.

2) Preserve and collect evidence

Collect everything that supports your claim:

• Police reports and crash reports.
• Medical records, treatment notes, test results, and bills.
• Photos of the scene, vehicles, injuries, and damage.
• Names and contact details for witnesses.
• Repair estimates, lost-wage proof, and any receipts related to the accident.

3) Try an internal appeal with the insurer

Most insurers have an internal appeal or reconsideration process. Send a clear, organized appeal packet by certified mail (return receipt requested). Include:

• A short cover letter summarizing why the denial is wrong.
• New or overlooked evidence and a chronological statement of medical treatment and expenses.
• Copies (never originals) of medical records, bills, and the police report.
• A demand that the insurer reconsider and provide a written response within a reasonable time.

4) Use state complaint options

If internal appeal fails or the insurer stalls, file a consumer complaint with the New Jersey Department of Banking and Insurance (DOBI). The DOBI can investigate insurer practices, help enforce insurance rules, and sometimes get insurers to reevaluate claims. File a complaint here: https://www.state.nj.us/dobi/consumers/insurance/complaints/.

5) Consider alternative dispute processes

Depending on your policy and the denial reason, other processes may apply:

• Appraisal clauses or neutral evaluation for property damage claims.
• Arbitration or mediation if your policy or the parties agree.
• Uninsured / underinsured motorist (UM/UIM) arbitration if the denial concerns UM/UIM coverage—check your policy provisions and the insurer’s dispute procedures.

6) Demand letter and settlement negotiation

If the insurer will not reverse the denial, a formal demand letter from you or an attorney can summarize liability, injuries, and damages and request a specific settlement amount. This often restarts negotiations and can produce a resolution without court.

7) Filing a lawsuit

If all administrative remedies fail, you may file a civil suit. For many auto-related personal injury claims in New Jersey, the statute of limitations is generally two years from the date of the accident. Protecting your right to sue means you must watch that deadline closely. For guidance on small claims and civil filing procedures, review New Jersey Courts resources: https://www.njcourts.gov/selfhelp/.

8) When insurer misconduct may permit a bad-faith claim

If the insurer unreasonably denies a valid claim, delays payment without cause, or misrepresents facts, you might have additional remedies beyond your underlying claim. These remedies often require proof of unreasonable conduct and, in New Jersey, may involve litigation and possible extra damages—consult an attorney to evaluate this possibility.

How to prepare before contacting an attorney

Even if you plan to hire an attorney right away, preparing these items will make consultations productive and may speed resolution:

• Chronological record of events and symptoms since the accident.
• Copies of all communications with the insurer, including denial letters and emails.
• Medical records, bills, and any insurance correspondence.
• Photos, police report, and witness contact information.
• Pay stubs or employer letters to support lost wage claims.

Practical timeline and expectations

Each case varies, but you can expect:

• Initial insurer review and denial: days to a few weeks.
• Internal appeal and reconsideration: 2–8 weeks typically.
• State complaint investigations: often several weeks to months.
• Mediation or negotiation: days to months, depending on complexity.
• Filing suit and resolving in court: months to years if litigation becomes necessary.

Act early to preserve evidence and meet statutory deadlines.

When to hire a New Jersey attorney

Consider hiring an attorney if any of the following apply:

• Your injuries require substantial medical treatment.
• The insurer denies liability or minimizes your damages without a clear basis.
• You face complex coverage issues (UM/UIM, disputed fault, multiple insurers).
• There is a possibility of insurer misconduct or you need help preserving legal rights and deadlines.

An attorney can prepare a demand, handle negotiations, and, if needed, file suit and pursue damages in court.

Relevant New Jersey resources

• New Jersey Department of Banking and Insurance — consumer complaint information: https://www.state.nj.us/dobi/consumers/insurance/complaints/
• New Jersey Courts — self-help information on filing and timelines: https://www.njcourts.gov/selfhelp/
• New Jersey Legislature — search laws and statutes: https://www.njleg.state.nj.us/laws-statutes