What to Do When Your Insurance Claim Is Denied

I never thought I’d need serious legal advice—until a rainy Thursday flipped my life upside down.

That morning, I was driving home from a client meeting when a speeding SUV ran a red light and T-boned my car.

The crash left me with a fractured rib, a damaged shoulder, and over ₦2 million in medical bills. Naturally, I filed a personal injury claim through my auto insurance provider, fully expecting my insurance policy to cover it. I mean, that’s what premiums are for, right?

Wrong.

Two weeks later, I received a cold, standard rejection letter: Claim denied due to insufficient medical documentation and liability concerns.

I was furious. I had x-rays, eyewitnesses, police reports—everything. I called their customer care line over five times. Each time, they passed me from one department to another like I was a hot potato.

So, I contacted a friend who connected me with a personal injury lawyer specializing in insurance disputes. He told me, “They’re stalling. Happens all the time with large claims. But there’s a way to fight this.”

He helped me draft a demand letter, citing clauses from the Nigerian Insurance Act and emphasizing bad faith insurance practices. We even requested a fraud investigation into the adjuster handling my case.

That got their attention.

But here’s where it got weird.

In the process of gathering evidence, my lawyer subpoenaed internal claim logs. Hidden deep in those logs, we found something shocking: the adjuster had classified my case as “high-risk payout” before reviewing my documents. He used a templated excuse to fast-track the denial and even logged a private note that said:

“Claimant likely won’t lawyer up. Too young, under-informed.”

Big mistake.

It turns out the adjuster had been running a side scam—denying valid claims to meet internal performance metrics and collect bonuses.

The legal team at the insurance firm panicked. Within 48 hours of receiving our findings, they offered me a ₦5 million settlement “for the inconvenience” and asked me to sign an NDA.

But my lawyer advised me to wait.

Instead, we filed a formal complaint with NAICOM (National Insurance Commission), and a class action lawsuit was launched after two more claimants came forward with similar stories. Long story short, the adjuster was fired, and I received a full payout—plus an additional ₦2 million in damages.

The best part?

My story made its way to a legal blog, and now I freelance as a contributor, educating others on insurance claim denial, legal loopholes, and how to fight back with the right lawyer.

So yeah, if you’re ever told your insurance claim is “not covered,” don’t accept it at face value. Sometimes, it’s not the law—it’s the person behind the desk.

And sometimes, all it takes to win… is knowing your rights.