Detailed Answer — what to do after a denial

When an insurer denies a bodily-injury claim after a minor crash, the process to challenge that denial generally follows these steps: understand the denial; gather and organize evidence; pursue the insurer’s internal appeal process; send a clear written demand; consider regulatory complaints or court action; and, if needed, consult an attorney. Below is a practical breakdown of each step under Pennsylvania law and common practice.

1. Read the denial carefully

The denial letter should say why the insurer denied coverage or payment (for example, late notice, insufficient medical proof, or a coverage exclusion). Note any deadlines the letter lists for appeals, additional evidence, or reconsideration.

2. Confirm basic deadlines — statute of limitations and policy timing

Don’t lose the right to sue if the insurer won’t pay. In Pennsylvania, most personal injury claims must be filed within the state statute of limitations. For typical negligence/personal-injury cases the limitations period is set by statute; see 42 Pa.C.S. § 5524. You can read the statute here: 42 Pa. C.S. § 5524. Also check your insurance policy: it may contain shorter internal deadlines for first-party claims or arbitration clauses.

3. Gather and organize evidence

Assemble a claim packet that typically includes:

• Police or accident report and crash photos
• Medical records, charts, and physician notes showing injury and treatment
• Medical bills and receipts
• Proof of lost wages (if any)
• Witness statements and photos of vehicle damage or scene
• Copies of all communications with the insurer (emails, letters, recorded calls if legal in your state)

4. Use the insurer’s internal appeal and grievance process

Most policies and carriers offer an internal appeals process. Send a concise, written appeal that:

1. Explains why the denial is incorrect (tie facts to policy language)
2. Includes the assembled evidence
3. Requests a date by which the insurer must respond

Send via certified mail and keep copies. If the insurer has a consumer complaint or grievance form, complete it and retain a copy of submission confirmation.

5. Send a demand letter if the internal appeal fails

If the insurer still refuses, send a demand letter summarizing the facts, how the policy covers the claim, the damages you seek, and a deadline to respond. A demand letter creates a clear record and sometimes prompts negotiation.

6. File a complaint with the Pennsylvania Insurance Department

If you suspect the insurer acted unfairly or failed to investigate, you can file a consumer complaint with the Pennsylvania Insurance Department. The Department reviews complaints, may mediate, and can investigate unfair claims handling practices. Learn more or file at: insurance.pa.gov.

7. Consider bad-faith and litigation options

If the carrier acted unreasonably, knowingly false, or in bad faith, Pennsylvania law permits a policyholder to seek remedies beyond the policy amount in some cases. The statute that courts rely on is 42 Pa.C.S. § 8371, which allows a court to award additional damages, interest, and attorneys’ fees when an insurer acted in bad faith. See the statute here: 42 Pa. C.S. § 8371.

Filing a lawsuit is typically a last resort. Depending on the amount at issue, you may sue in small claims or civil court. Pennsylvania’s magisterial district courts or civil courts have jurisdictional limits and procedures — the Pennsylvania Courts website explains local filing rules and which court to use.

8. Alternative dispute resolution

Some insurance policies require or allow mediation or arbitration. Arbitration can be faster but may limit your ability to appeal. Carefully read the policy and consider whether arbitration fits your goals.

9. When to talk to a lawyer

Consider a consultation if:

• Injuries caused ongoing medical treatment or permanent impairment
• The insurer’s denial seems unreasonable or the insurer ignored key evidence
• You received a clear statutory or policy deadline and face imminent expiration
• You want help drafting a demand or determining whether a bad-faith claim exists

An attorney can review medical causation, policy language, and advise on damages and deadlines. If you hire counsel, they will typically send a demand and may file suit if negotiations fail.

Helpful Hints

• Act quickly. Preserve records and watch statute-of-limitation dates (see 42 Pa. C.S. § 5524).
• Keep a chronological file of all documents and communications. Dates matter in appeals and litigation.
• Request a copy of the insurer’s claim file if you suspect investigative errors; your attorney can obtain it formally through discovery if you file suit.
• Be concise and factual in written appeals. Tie each piece of evidence to why it proves coverage or damages.
• Do not sign away rights without understanding consequences. Avoid quick settlement offers until you know the full extent of injuries and bills.
• If your case is small and medical issues are minor, a clear demand with supporting records often resolves the dispute without litigation.
• If you believe the insurer acted in bad faith, document unreasonable delays, lack of investigation, or contradictory statements; those facts relate to claims under 42 Pa. C.S. § 8371.
• File a complaint with the Pennsylvania Insurance Department if you cannot resolve the dispute directly: insurance.pa.gov.