Skip to Main Content
Call for a free Consultation 503-546-3167
header banner

Insurance Denials and Claims

header video background play button

About Johnston Law Firm


We Handle Medical Denials & Claims in Portland and Throughout Oregon

Life is full of troubling circumstances and families, individuals and businesses purchase insurance to protect themselves from financial difficulties when those unexpected situations come up. When your insurance company disputes or denies your claim, you should contact a Portland insurance claim denial lawyer.

Was Your Insurance Claim Denied? We’re Here to Help.

If you have been seriously injured due to another person or organization’s negligent actions, you should be compensated for your injuries. After all, you have been paying the premiums for years. What we see at the Johnston Law Firm is insurance companies challenging or disputing your claim. They refuse to pay you the money you are owed, and provide a long list of exclusions and reasons why. As your attorney, we are confident in our ability to negotiate with your insurance company, and the insurance company of the liable party, and work toward recovering full and fair compensation on your behalf.

Our firm provides legal advice and representation to residents of communities throughout Oregon and Washington in a wide array of insurance coverage disputes, including:

While the above list reflects the types of insurance coverage disputes we handle most frequently, we encourage you to contact us with disputes not referenced here. If we are unable to help you, we will make sure to point you in the right direction so you can get the help you need and deserve.

At the Johnston Law Firm, we do not handle insurance claims involving damage to property.

Why Your Insurance Claim May Be Contested or Denied

An insurance company wants to dispute or deny your claim because doing so will save it money in the long run. In fact, one of the primary jobs of an insurance adjuster is to find ways to reduce the value of your claim. That being said, in order to actually deny or dispute your claim, the insurance adjuster will need to come up with a valid (or seemingly valid) reason. Common reasons why an insurance claim may be contested or denied include:

  • The insurance adjuster claims a policy exclusion. One of the ways that an insurance adjuster will try to deny your claim and save the insurance company money is to claim that a policy exclusion exists. This means that while the insurance adjuster is indeed recognizing that you’ve suffered an injury or damages and should be compensated, they’re also saying that your policy doesn’t cover those specific damages or the way in which they were incurred. This is especially common with homeowners’ insurance claims, but can also happen with motor vehicles and other injury claims, too.
  • You’re told that you didn’t give the insurance company enough notice. When you are involved in an accident and suffer damages, you have a duty to provide your insurance company with notice of the accident within a reasonable amount of time. Typically, our lawyers recommend that you provide notice within 24-48 hours; however, you should check your policy to determine whether or not there is a specific time frame in which you must report, or else risk claim denial.

  • You have a pre-existing condition. If you have a preexisting condition, an insurance adjuster could use this against you to claim that they don’t owe you money for a new injury you’ve suffered, because that ‘new” injury was actually preexisting. For example, say you had a knee surgery two years ago, and in your slip and fall accident, that injury was seriously aggravated to the point that you need a second surgery. While an insurance adjuster may try to get off the hook for paying for this, you deserve to be compensated for all new injuries you sustain, including the worsening or aggravation of existing injuries.
  • You haven’t done your due diligence to avoid further injury/heal to the extent possible. When you are involved in an accident, it’s very important to follow your doctor’s orders related to your medical treatment. If you don’t, the insurance adjuster may argue that you didn’t do your due diligence to mitigate further harm and that if you had, you would have healed to a greater extent than you have. The best way to get ahead of this is to follow your doctor’s order to a T and to keep a thorough record of all the care you receive. We also recommend staying off of social media, as an insurance adjuster may try to follow you online to obtain evidence that can be used against you.
  • There are limited medical records. Another thing that may harm your claim is in the event that there are limited medical records/evidence to support your claim for injuries. For example, if you are claiming that you broke your arm in a car crash but there is no record of you going to the hospital after the crash, or if there is no record of an actual bone fracture, you’ll have a very hard time recovering a settlement. This is one of the reasons that we always advise our clients to seek medical care immediately after a crash, even if they don’t think they’ve been seriously injured. Make sure you request a copy of all of your medical bills, prescriptions, and other relevant documents, too.
  • The insurance adjuster argues that you were at fault for the accident. Finally, one way that an insurance adjuster may be able to wiggle out of paying your claim is by making the argument that you were at fault for the accident, and therefore their client’s liability insurance policy should have nothing to do with compensating you. Watch out for this argument, and be sure you have a skilled attorney on your side to protect you!
johnston profile

Contact a Portland Insurance Claim Denial Lawyer

If you have questions regarding insurance coverage and denials, contact the Johnston Law Firm by calling 503-546-3167 or via the e-mail form on this website. We offer a free initial consultation and flexible hours by appointment.

Johnston Law Firm, P.C. proudly represents clients in all cities and counties in Oregon: Portland, Gresham, Milwaukie, Lake Oswego, Tigard, Beaverton, Hillsboro, Multnomah, Washington, Clackamas.

Don’t miss out on these common personal injury mistakes.

Get the legal counsel you need to guide you through the process of filing an injury claim.


play video

Sally Martinez September 28, 2020

star rating star rating star rating star rating star rating

– Michelle E.

star rating star rating star rating star rating star rating

Mr. Johnston and his firm were incredibly thorough in getting us a fair settlement from our insurance company with little to no pressure. We really appreciated having someone who truly cared about us every step of the way. I would highly recommend the Johnston Law Firm to anyone in need of personal injury representation.

Read more >


FAQs About Insurance Claims

Our lawyers strongly recommend against giving a recorded statement to an insurance company unless you’ve already spoken to an attorney who gives you the go-ahead. Giving a recorded statement is usually the first mistake, as anything you use in that statement can be used against you to deny your claim – and likely will be.

The insurance company has a duty to process your claim and do so at a reasonable pace – unreasonable delays are a sign of bad faith. If your insurance company isn’t returning your calls and an unreasonable amount of time has passed since you filed your claim, you should connect with an attorney who can represent you in talking to the insurance company.

What are my options? Another big mistake that people make is accepting an insurance offer that’s unfair and undercuts the value of their claim because they think they don’t have any other options. The truth is that you do have options, and you do not have to accept an unfair settlement offer! If you think that a settlement offer is unfair, we recommend talking to an attorney. An attorney can reject the settlement offer on your behalf and begin the negotiations process to reach a settlement that’s fair.

If your claim has been denied, you may feel as though you’re out of options. You have the right to appeal a denied claim, and you should. Before you start the process though, it’s recommended that you speak to an attorney who can represent you during the process and improve your chances of success.

In fact, insurance companies routinely deny claims until you hire an insurance coverage lawyer. Such tactics require a heavy hand, and an experienced insurance coverage lawyer. Having a dedicated advocate on your side forces the insurance company to take your claims more seriously. We will work to get a settlement, but our firm is comfortable representing you through insurance litigation in the courtroom if it becomes necessary. Sometimes, it is the only way to get your insurance company’s attention.

Free Confidential Case Evaluation

Contact us today at

to get a FREE, confidential case evaluation

We’re conveniently located in downtown Portland, and we offer flexible hours by appointment.