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What if the Insurance Company Denies My Claim?

• FAQ

Quick Answer

If an insurance company denies your claim, the right response depends on which claim was denied:

  1. Third-party claim denial (the other driver’s insurer denies liability), your primary remedy is usually to pursue the underlying injury claim against the at-fault person in court, because Nevada generally does not allow injured third-party claimants to sue the at-fault insurer directly for bad faith. Gunny v. Allstate Ins. Co., 108 Nev. 344, 830 P.2d 1335 (1992).
  2. First-party claim denial (your own insurer denies MedPay, UM, UIM, or other benefits), you may have contract remedies and, in appropriate cases, tort remedies for bad faith and statutory unfair claims practices. Ainsworth v. Combined Ins. Co. of Am., 104 Nev. 587, 763 P.2d 673 (1988); NRS 686A.310.

Either way, do not treat a denial as “the end.” A denial is a position, and it can often be challenged with evidence, litigation tools, and correct timing.

1) Get the denial in writing and identify the reason

Ask the adjuster to clearly state:

  1. The basis for denial (liability, causation, damages, coverage, exclusions, lack of cooperation, late notice).
  2. The facts the insurer relied on (statements, photos, reports, medical records).
  3. What additional information might change the decision.

This matters because many “denials” are actually one of these:

  1. A denial of fault (they claim their driver is not liable).
  2. A denial of causation (they claim the crash did not cause your condition).
  3. A denial of the amount (they accept some injury, but dispute scope of treatment).
  4. A coverage denial (policy lapsed, excluded driver, no permissive use, policy exclusions).

2) Third-party denial vs first-party denial

A) Third-party denial, the other driver’s insurer denies your bodily injury claim

This typically means the driver’s insurer is saying one or more of the following:

  1. Their insured was not at fault.
  2. You were primarily at fault, or fault is disputed under comparative negligence principles. NRS 41.141.
  3. Your injuries are not related, or not as serious as claimed.
  4. Their insured has limited coverage, or there are coverage defenses.

What you can do next
Your leverage is the tort claim against the at-fault party. The insurer’s denial does not decide liability, the factfinder does. If negotiations fail, filing a lawsuit against the negligent party is often the only way to compel evidence production and force a liability determination (NRCP 3; NRCP 16.1).

A key Nevada rule: injured third-party claimants generally cannot sue the at-fault insurer directly for bad faith under Nevada’s unfair claims practices statute. Gunny v. Allstate Ins. Co., 108 Nev. 344, 830 P.2d 1335 (1992). That is why your strategy focuses on building the case against the tortfeasor and proving liability, causation, and damages.

B) First-party denial, your own insurer denies benefits (MedPay, UM, UIM)

A denial by your own insurer is different because you have a contractual relationship with the insurer and Nevada recognizes first-party bad faith duties in appropriate circumstances.

Common next steps include:

  1. Submit missing documentation and request reconsideration.
  2. Escalate to a supervisor or claim review unit, in writing.
  3. Evaluate whether the denial is a breach of contract.
  4. Evaluate whether the denial or delay supports a bad faith claim.

Nevada recognizes insurer bad faith in appropriate first-party contexts and has addressed standards and remedies in multiple decisions. Ainsworth v. Combined Ins. Co. of Am., 104 Nev. 587, 763 P.2d 673 (1988); Pemberton v. Farmers Ins. Exch., 109 Nev. 789, 858 P.2d 380 (1993); Guar. Nat’l Ins. Co. v. Potter, 112 Nev. 199, 912 P.2d 267 (1996); Allstate Ins. Co. v. Miller, 125 Nev. 300, 212 P.3d 318 (2009). Nevada’s unfair claims practices statute can also be relevant. NRS 686A.310.

3) The evidence that most often reverses a denial

Most denials fall apart when one of these evidentiary gaps gets filled:

A) Liability proof

  1. Scene photos and videos, including angles, skid marks, lane markings, signals.
  2. Neutral witnesses and written statements.
  3. Video from nearby businesses or dash cams.
  4. Accident reconstruction evidence in significant cases.

B) Medical causation proof

If the insurer says “not related,” build causation with:

  1. Prompt evaluation and accurate history.
  2. Consistent symptom reporting.
  3. Objective findings when available.
  4. Treating physician documentation using probability-based language when needed.

Nevada recognizes that medical causation often requires expert testimony stated to a reasonable degree of medical probability when the causal question is beyond common knowledge. Morsicato v. Sav-On Drug Stores, Inc., 121 Nev. 153, 111 P.3d 1112 (2005); Williams v. Eighth Judicial Dist. Court, 127 Nev. 518, 262 P.3d 360 (2011).

C) Coverage proof

If the denial is coverage-based, you often need:

  1. The declarations page and full policy.
  2. Proof of payment and effective dates.
  3. Driver permissive use facts.
  4. Employer or umbrella policies, if any.
  5. UM and UIM selection or rejection documents, when relevant. NRS 687B.145.

4) Be careful with recorded statements, they can become evidence

Denials are often built on statements, especially statements taken early.

Nevada law addresses discovery and privilege issues surrounding insurer investigation materials, and it is not safe to assume a recorded statement will remain confidential or protected. Ballard v. Eighth Judicial Dist. Court, 106 Nev. 83, 787 P.2d 406 (1990). Your own statements can also be used against you as admissions. NRS 51.035.

5) Do not miss the deadline while you argue with an adjuster

A denial does not pause the statute of limitations.

Most Nevada personal injury actions must be filed within two years. NRS 11.190(4)(e). If you wait too long, the case can become time-barred even if the denial was wrong.

Nevada legal authorities cited

  • NRS 11.190(4)(e).
  • NRS 41.141.
  • NRS 51.035.
  • NRS 686A.310.
  • NRS 687B.145.
  • NRCP 3.
  • NRCP 16.1.
  • Ainsworth v. Combined Ins. Co. of Am., 104 Nev. 587, 763 P.2d 673 (1988).
  • Allstate Ins. Co. v. Miller, 125 Nev. 300, 212 P.3d 318 (2009).
  • Ballard v. Eighth Judicial Dist. Court, 106 Nev. 83, 787 P.2d 406 (1990).
  • Guar. Nat’l Ins. Co. v. Potter, 112 Nev. 199, 912 P.2d 267 (1996).
  • Gunny v. Allstate Ins. Co., 108 Nev. 344, 830 P.2d 1335 (1992).
  • Morsicato v. Sav-On Drug Stores, Inc., 121 Nev. 153, 111 P.3d 1112 (2005).
  • Pemberton v. Farmers Ins. Exch., 109 Nev. 789, 858 P.2d 380 (1993).
  • Williams v. Eighth Judicial Dist. Court, 127 Nev. 518, 262 P.3d 360 (2011).

If you need assistance with your personal injury case, don’t hesitate to contact Friedman Injury Law.


Friedman Injury Law
375 N. Stephanie St., Ste. 1411
Henderson, NV 89014
P: (702) 970-4222
W: blakefriedmanlaw.com

@friedmaninjurylaw_