What to Do When the Insurance Company Denies Your Car Accident Claim

A denial letter is written to sound final. It is not. Insurers deny claims for reasons that range from genuinely defensible to plainly wrong, and a meaningful share of denials are reversed once somebody sends back the specific proof the adjuster claims is missing rather than a phone call arguing about it.

This post covers how to read a denial, which grounds tend to collapse under evidence, and what Colorado law lets you do when the refusal was not reasonable. The Denver car accident attorneys at Boesen Law handle denied claims regularly, including several that became some of our largest recoveries.

Read the Letter Before You Answer It

Every denial contains a stated ground, and the ground determines everything you do next. Pull the letter apart into four questions.

Which policy denied you? The at-fault driver’s liability carrier and your own insurer occupy different legal positions, and the tools available to you differ completely depending on which one sent the letter. Sorting that out starts with knowing which of your Colorado auto insurance coverages were in play.

What is the stated basis? Liability, coverage, causation, and lateness are four different arguments. A liability denial says their driver did nothing wrong. A coverage denial says the policy does not respond at all. A causation denial concedes the crash and disputes the injury. A late-notice denial ignores the merits entirely.

What does the letter say is missing? Adjusters often name the exact document that would change the answer, then close the file when nobody sends it.

What deadline does the letter impose? Internal appeal windows and policy suit-limitation clauses are contractual and short. They are not the same thing as the statutory filing deadline.

For answers to your questions, call:
(303) 999-9999

The Grounds Carriers Actually Use

Most denials in Colorado crash claims fall into a handful of categories, and each becomes attractive to a carrier long before anyone tests it. The role insurance companies play in Denver personal injury claims is to price risk, and an unchallenged denial prices it at zero.

• Disputed liability. Their insured told a different story and the adjuster believed it, often because no independent evidence contradicted it.
• Comparative fault. Colorado reduces a recovery by the claimant’s share of the blame and bars it once that share exceeds the other party’s, so an inflated percentage assigned early does the work of a denial. This is why how comparative negligence affects car accident cases deserves attention the moment a percentage appears in writing.
• Pre-existing condition. The most common causation denial, and the most beatable one, because degenerative findings appear on the imaging of most adults regardless of whether they were in a crash.
• Gap in treatment. A three-week break between appointments becomes an argument that you recovered and then hurt yourself elsewhere.
• Late notice. Reporting the crash weeks after it happened, particularly on a first-party claim.
• Policy exclusions or lapse. The vehicle was not on the policy, the premium was unpaid, or the driver was excluded by name.
• Alleged misrepresentation. Something you said in a recorded statement, quoted back without the sentence around it.

A First-Party Denial and a Third-Party Denial Are Different Problems

This distinction controls your remedies, and most people denied after a crash never hear it explained.

Your own insurer owes you duties. Medical payments coverage, collision, and uninsured and underinsured motorist coverage are first-party benefits. You are the insured. The carrier has contractual obligations to you and a duty of good-faith claims handling that Colorado enforces by statute.

The other driver’s insurer owes you nothing directly. You are a third-party claimant with no contract with that company. Its duty of good faith runs to its own policyholder, not to you. When that carrier denies your claim, the answer is not an appeal, because there is nothing to appeal to. The answer is a lawsuit against the driver, which is what puts the carrier’s money at risk.

Sorting a denial into the right category on day one prevents months spent appealing to a company with no obligation to reconsider anything.

What Colorado Law Says About an Unreasonable Denial

For first-party claims, Colorado does more than disapprove of bad denials. C.R.S. § 10-3-1115 prohibits an insurer from unreasonably delaying or denying payment of a claim for benefits owed to a first-party claimant, and defines a delay or denial as unreasonable when the carrier acted without a reasonable basis.

Section 10-3-1116 supplies the consequence. A first-party claimant whose benefits were unreasonably delayed or denied may bring an action in district court to recover reasonable attorney fees, court costs, and two times the covered benefit, and that remedy sits on top of, rather than in place of, other claims available at common law.

Two features make this provision matter in practice. The claimant does not have to prove the carrier acted maliciously, only that it lacked a reasonable basis. And the statutory damages are calculated on the benefit, so a carrier sitting on an underinsured motorist claim it cannot justify is exposed well beyond the policy limit it was trying to protect.

The statute reaches first-party claimants only. It expressly excludes a person asserting a claim against an insured under a liability policy, which is precisely the position you occupy against the other driver’s carrier.

The Steps That Actually Reverse a Denial

1. Get the claim file requirements in writing. Ask the adjuster to identify, by name, every document the company says it is missing. Written requests are harder to move later.
2. Attack the stated ground, not the outcome. A pre-existing condition denial is answered with prior imaging, a treating physician’s causation opinion, and a records chronology showing the symptoms began after the collision. Arguing that the denial is unfair changes nothing.
3. Rebuild the liability proof the adjuster never had. Signal timing records, event data recorder downloads, corridor video, and a scene reconstruction go directly at a disputed-fault denial by establishing the elements of a negligence claim with something other than two conflicting accounts.
4. Close the treatment gaps on paper. A documented reason for a break in care, whether cost, work, or a referral wait, removes the inference the carrier is drawing from it.
5. Document the mechanism of injury. Soft-tissue denials turn on specificity, which is why the steps to build a whiplash claim start with describing the direction of impact to every provider who examines you.
6. Change who is asking. A denial reviewed after a demand from counsel, with a suit deadline attached, is a different conversation than a denial reviewed after a call from a claimant.

Filing a Complaint With the Division of Insurance

The Colorado Division of Insurance takes consumer complaints about claim handling and will contact the company to review whether it complied with state insurance law. The Division is candid about its limits: it does not decide coverage or liability, and it notes that Colorado’s insurance laws contain no fixed timeframes for a company to respond to your communications, although it can address unreasonable delay with the carrier directly.

That makes a complaint to the Division a useful pressure point and a poor substitute for a claim. File one where the handling looks improper, and keep building the case in parallel.

Was Your Denial Defensible?

Barry I. Dunn, a Colorado trial lawyer with more than twenty-eight years of experience and a reputation for leaving no stone unturned, notes:

“A denial letter tells you what the carrier thinks it can defend, and that is genuinely useful information. When the reason is a pre-existing condition, they are betting nobody will produce the prior imaging. When the reason is comparative fault, they are betting nobody will get the video. I have taken over files that were denied outright and resolved them in six figures without anything changing except that somebody went and collected the proof the adjuster assumed did not exist. The denials that hold up are the ones where the policy truly does not cover the loss. Those are far rarer than the letters suggest.”

If your own carrier denied a first-party benefit, have the file reviewed for statutory exposure before you accept the explanation. The remedy under § 10-3-1116 changes what the claim is worth.

What Cases Like Yours Have Recovered

• $475,000 for a client rear-ended by an FBI vehicle whose prior spinal issues worsened into a required spinal surgery. The physical injuries were initially refused outright.
• $300,000 for a client T-boned by a reckless driver who ran a red light, leaving a concussion, significant whiplash, and overall body pain, in a case where the legal expenses of pressing it had been a real obstacle.

Boesen Law took both files after the easy answer had already been given. Our case results show what happens when a denial gets tested.

Contact a Denver Car Accident Lawyer at Boesen Law

The costliest response to a denial is treating it as a verdict. Claims get closed every week in Colorado because the letter sounded authoritative and nobody sent back the one document that would have changed it.

Your recovery is our priority at Boesen Law, and decades of Colorado injury work sit behind that. We take calls 24 hours a day, we work with clients in English, Russian, and Spanish, and you owe no attorney fee unless we recover compensation for you. Bring the denial letter and every piece of correspondence attached to it to a free, in-person consultation, and we will tell you which parts of it will hold. Contact Boesen Law to get on the calendar this week.

FAQs About a Denied Car Accident Claim in Colorado

Does the denial letter have to tell me why?

It has to give you a stated basis, and that basis is the thing worth examining. A vague letter citing an investigation without identifying what the investigation concluded is itself a signal, because a carrier confident in its position generally says what the position is. Write back and ask for the specific policy provision or factual finding relied on, and keep the exchange in writing. If the company will not commit to a reason, it will have difficulty defending one later.

Can I appeal a denial from the other driver’s insurance company?

Not in any formal sense, because you have no contract with that company and it owes its duty of good faith to its own policyholder. What replaces an appeal is a claim against the driver personally, which brings the insurer’s money into the dispute through its obligation to defend and indemnify. In practice, most third-party denials get revisited only after a demand from a lawyer with a filing deadline behind it.

Will my own insurance rates go up if I use my coverage after a denial?

Using benefits you paid for in a crash you did not cause is a different matter than an at-fault loss, and medical payments and underinsured motorist coverage exist precisely for this situation. Weigh that against the alternative, which is medical bills going to collections while a third-party carrier that owes you nothing decides whether to reconsider. Your own coverage also carries a statutory good-faith obligation the other driver’s carrier does not.

How long do I have to sue after my claim is denied?

The denial does not extend anything. A motor vehicle injury claim in Colorado runs on a three-year deadline measured from the crash, and the filing deadlines for personal injury claims keep running through every round of correspondence with an adjuster. Your policy may also contain a separate and shorter suit-limitation clause on first-party benefits. Months spent appealing consume the same calendar that a lawsuit would need.

The adjuster says my MRI shows degeneration, not injury. Is that the end of it?

No, and it is one of the most common grounds a carrier tries. Degenerative findings are present on the imaging of most adults past their twenties and say nothing about whether a collision made an existing condition symptomatic. Colorado law lets you recover for the aggravation of a pre-existing condition, and the proof is a treating physician comparing your function before and after, supported by records showing when the symptoms and the restrictions began.

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