The Insurance Company Denied Our Daycare Claim — Even With Video Evidence. Here’s What Happened Next

When the Evidence Is Clear but the Answer Is Still No

A few months ago, I received a call about a child who had been seriously injured at a daycare facility. The facts were not complicated. The child was at the top of a slide on the daycare playground when another child deliberately shoved her.

She fell from the top of the slide, landed on the ground, broke her arm, and required surgery. The incident had been captured on the daycare’s surveillance cameras. The injury was well-documented. The mechanism was clear.

When we filed the claim with the daycare’s insurance company, I expected a serious and productive conversation. Instead, the adjuster denied liability.

Despite the footage. Despite the surgical fracture. Despite the documentation of exactly what happened, the insurance company told us there was no case. I hear that phrase a lot. And in my experience, it is almost never the final word.

The Critical Role of Prior Notice in Liability Cases

Prior notice plays a critical role in liability cases because it helps establish whether a party knew about a dangerous condition before the incident. In an insurance claim, proving that a daycare or facility had prior knowledge can strengthen the case and show that the injury was preventable. Without this notice, insurers may argue the incident was unexpected and not covered under the policy.

Medical records can help connect the cause of the injury to the known risk, making it harder for the insurance company to deny responsibility. Each state has specific rules about how notice must be shown, so understanding local requirements is important.

Even though terms like auto insurance or a car insurance policy are more common in vehicle cases, the principle is similar: coverage often depends on what was known and reported. If your claim is denied, it is important to contact a lawyer who can review the policy, challenge the denial, and help ensure the insurance claim is properly evaluated and covered.

The Adjuster’s Position: Why They Said No

To understand why the adjuster denied the claim — and why that denial was wrong — it helps to understand the legal framework the adjuster was relying on. Daycares are not held to a standard of perfection.

They cannot be expected to prevent every single act of aggression that one child commits against another, in every location on their property, at every moment of the day. The law does not require that kind of omniscience or omnipresence. It requires reasonable supervision — appropriate oversight given the age of the children, the setting, and the foreseeable risks.

The adjuster’s position was that requiring a staff member to be physically stationed at the bottom of every slide, watching every child at every moment, was an unreasonable standard.

One child pushing another in a moment when no adult happened to be looking directly at that spot was, in the adjuster’s view, an unforeseeable incident that a daycare cannot be expected to prevent through any reasonable measure. That argument, standing alone, has some legal logic to it.

But it was also fundamentally incomplete. Because the adjuster was looking at the wrong question.

What the Adjuster Got Wrong: The Prior Notice Problem

The relevant legal question in this case was not whether the daycare should have had someone at the bottom of that slide at that specific moment. The relevant question was what the daycare knew about the child who did the pushing — and what they had done about it. The answer to the second question was: nothing.

The child who pushed my client off the slide had a documented history of aggressive behavior at the daycare. She had pushed other children before — on multiple occasions, in multiple settings. Other parents had reported the behavior.

The daycare was fully aware that this child had a pattern of pushing peers, particularly on playground equipment. That awareness — that specific, documented, prior notice of ongoing dangerous behavior — is what changes everything legally.

Once a daycare has specific knowledge that a particular child is repeatedly and dangerously aggressive toward other children, the facility has an obligation to take some form of meaningful action to prevent future incidents. Not necessarily to station a permanent adult guardian at the child’s elbow at all times — but to do something reasonable in proportion to the known risk. Increased supervision of the aggressive child during outdoor play.

A behavioral intervention plan. A conversation with the child’s parents that escalated the seriousness of the situation. Temporary restriction from elevated playground equipment. Any of these responses would have demonstrated a good-faith effort to address the known problem.

The daycare did none of these things. And when the predictable result of ignoring a known risk occurred — a child with a documented pushing pattern pushed another child — the facility’s decision to do nothing transformed what might have been an unavoidable accident into actionable negligence.

What Daycares Should Do When Aggressive Behavior Is Reported

When aggressive behavior is reported, daycares must act immediately to protect every kid in their care. Staff should document the incident with a clear picture of what happened, speak with witnesses, and notify parents, including the parent of the son involved. A consistent response is essential, meaning policies must be followed every time without exceptions.

The daycare should separate the children, assess any injuries, and recommend that a doctor evaluate the child if needed. In serious situations, contacting police may be appropriate to ensure safety and proper reporting. Clear communication helps prevent confusion later, especially if an insurer becomes involved.

If a daycare fails to respond properly, it may lead to higher expense and cost for families and could even result in disputes where insurers try to deny your claim. Proper documentation and consistent action also prepare the case if it reaches court, showing the daycare took or failed to take reasonable steps.

The Legal Standard: Duty to Act on Known Risks

The principle at work in this case appears frequently in daycare and premises liability litigation. It is sometimes described as the duty to act on known or foreseeable risks. The law does not require institutions to prevent all harm — it requires them to take reasonable steps to prevent harms they have specific reason to anticipate.

When a daycare is put on actual notice of a specific, ongoing safety problem and chooses not to address it, the next injury that results from that problem is one they had both the ability and the legal obligation to try to prevent.

The prior notice doctrine is the cornerstone of many successful daycare negligence claims. It is also the element that insurance adjusters most often overlook, minimize, or choose not to investigate thoroughly in their initial assessment of a claim.

Adjusters are looking for reasons to deny. Building a case around prior notice requires digging into records, reviewing incident reports, interviewing witnesses, and constructing a timeline that shows what the daycare knew, when they knew it, and what they chose to do — or not do — in response. That is the work of an attorney, not an adjuster conducting an initial review.

Why an Insurance Denial Is the Beginning, Not the End

An insurance company’s denial of a claim is a business decision, not a legal judgment. Adjusters are not judges. Their denials carry no legal weight beyond the immediate claims process.

They reflect one party’s self-interested assessment of its exposure — and that assessment is frequently wrong, incomplete, or deliberately conservative in the hope that the claimant will accept the denial and move on.

In this case, once it became clear that we were not going to accept the denial and that we were prepared to pursue litigation, the insurance company’s position became far less certain.

The prior notice evidence — the documentation of the prior incidents, the prior reports, and the daycare’s failure to respond — fundamentally shifted the case. The outcome of that case is part of an ongoing process, but the initial denial was not the end of the story. It never is.

How Legal Action Can Shift the Case in Your Favor

When an insurance company denies a daycare claim, even with video evidence, legal action can change the direction of the case. Filing a lawsuit forces a deeper review of the facts, including the footage, incident reports, and any prior complaints. It also requires the insurer and daycare to respond under legal pressure rather than relying on a simple denial.

Through legal discovery, additional evidence may come to light, such as staff records or internal communications that were not initially shared. This process can strengthen your position and highlight inconsistencies in the denial.

Legal action also increases the risk for the insurance company, which may lead to a more favorable settlement. Instead of relying on their initial decision, you gain leverage to challenge their conclusions and present a stronger case. This shift often results in a fairer outcome that better reflects the harm your child experienced.

FAQs

What should we do after receiving a denial letter?

Review the denial letter, check all evidence, disclose complete medical records, and respond to any inconsistent findings to strengthen your case.

Can you still recover medical bills after a denial?

Yes, if the claim is legitimate, you can challenge the decision, provide additional proof of damage, and pursue recovery of medical bills under the proper coverage.

Why would an insurance company deny a claim even with video evidence?

An issue can arise if the insurer finds details inconsistent, questions coverage, or believes the claim is not legitimate despite video, medical records, and documented damage.

What You Should Do If Your Daycare Claim Has Been Denied

If you have filed a claim related to your child’s injury at a daycare, school, or camp and the insurance company has denied it, do not treat that denial as the final answer. Speak with an attorney who handles these cases and have them evaluate the denial specifically.

Ask whether prior incidents involving the same hazard or the same child were investigated. Ask whether the evidence of prior notice was fully developed and presented. Ask whether all relevant documentation was gathered and reviewed.

Denials are challenged and overturned regularly in personal injury cases. The insurance company has a financial incentive to deny claims.

You have a legal right to fight those denials. And with the right evidence, the right legal theory, and the right representation, a denial that initially seems final can become the starting point for a very different outcome.