Imagine getting into a car accident that was clearly not your fault. You do what you have always been told to do, and you file an insurance claim. After a potentially lengthy process, you find out that your claim was denied. What do you do now?
An experienced car accident attorney can oversee the insurance claim process. You do not have to do any part of the insurance claim process alone. Do not delay. Contact a lawyer now to learn more about your legal rights after a denial of a car insurance claim.
How Often Do Insurance Companies Deny Car Accident Claims?
Insurance companies regularly deny claims, even if it seems to be for no good reason. According to some statistics, insurance companies deny around five to 15 percent of all submitted claims. The reasons that insurance companies deny car accident claims can vary based on the details of the crash. Some common reasons insurance companies typically deny claims are detailed below. Just know that if you believed you had a valid claim and received a denial, you are certainly not alone.
How Common Are Car Accidents Nationwide?
Car accidents happen every day across the United States. According to statistics published by the National Highway Traffic Safety Administration, thousands of people died over the past several years in car accidents. Fatal car accidents took the lives of 40,000 people in America in one recent year. According to the same statistics, 45 percent of deadly crashes and traffic accidents involved at least one risky driving behavior like speeding, not wearing a seatbelt, or alcohol impairment.
Why Do Insurance Companies Deny Car Accident Claims?
Insurance companies may deny car accident claims for a variety of reasons, ranging from issues with coverage to disputes over liability or damages. Below are the most common reasons an insurance company might decide to deny your car accident claim.
Uninsured Hit-and-Run Drivers
Unfortunately, some drivers leave the scene of an accident before exchanging the minimum information required by law. This leaves accident victims without the protection of blaming the insurance company’s insured for the accident. If the at-fault party was uninsured and you don’t have active uninsured motorist coverage, your claim might be denied. In hit-and-run cases, the lack of an at-fault party’s identity can complicate claims.
Disputes Over Damages
The insurer might argue that the repair costs are inflated or unrelated to the accident. They may claim your injuries are not as severe as stated or not directly caused by the accident. If the claimed damages exceed the policy limits, the insurer may refuse to pay beyond those limits.
Pre-Existing Conditions or Fraud Suspicions
The insurer may claim that your vehicle or injury predated the accident. If the insurance company suspects you are exaggerating or fabricating the claim, they may deny it.
Failure to Comply With Policy Requirements
Most insurance policies require accidents to be reported within a specific timeframe. Delays can result in denial. If you do not seek immediate medical care, the insurer might argue that your injuries were not caused by the accident. Violations, such as driving under the influence or engaging in illegal activity at the time of the accident, can void coverage.
Lack of Evidence
If you fail to provide adequate evidence, such as photos, police reports, or medical records, the insurer may deny the claim. Some insurers require a police report to process claims. If none exists, the claim can be rejected.
Disputes Over Liability
The insurer may claim their policyholder was not at fault and argue that you or another party was fully responsible for the accident. This can complicate the situation and require additional evidence to overturn the denial.
Policy-Related Issues
The policyholder’s insurance coverage may have expired or been canceled due to non-payment or other issues. If the person driving the vehicle at the time of the accident was not listed on the policy or was explicitly excluded, the claim might be denied. Some policies have restrictions on specific types of accidents or may exclude coverage for certain scenarios. The type of coverage may not apply to the specific claim.
Common Bad Faith Tactics From Insurance Companies
Insurance companies aim to minimize payouts to protect their profits. Understanding the common reasons for claim denials and taking proactive steps can improve your chances of successfully resolving your claim.
Insurance companies are legally obligated to act in good faith and deal fairly with policyholders and claimants. However, some engage in bad faith tactics to delay, reduce, or avoid payments. Recognizing these tactics is crucial to protecting your rights. Here are some common examples of bad faith tactics used by insurance companies:
Refusing To Settle Legitimate Claims
Refusing to engage in good faith negotiations for a fair settlement is a common insurance company tactic. Also, insurance companies commonly disregard case law or established legal standards in their decision-making.
Disputing Valid Costs
Insurance companies regularly dispute valid claims and costs to save their bottom lines. Refusing to pay for necessary medical treatments, claiming they are excessive or unrelated, or using only preferred vendors to provide artificially low estimates for vehicle or property repairs are also common tactics.
Rescinding Policies After a Claim
Attempting to cancel a policy retroactively after a claim is filed, often by alleging misrepresentation during the application process is a common tactic used by insurers.
Failing To Communicate or Act Promptly
An insurance company might act slowly. Missing any legally mandated deadlines for claim responses or payments might help companies avoid making payments. Further, failing to communicate progress on the claim leaves claimants in the dark about their claim’s progress.
Claiming Pre-existing Conditions
An insurance company might claim that the injuries you suffered were not caused by the accident. Blaming injuries on pre-existing issues and arguing that your injuries or damages existed before the accident and are not related to the claim is a common insurance tactic.
Using Intimidation or Coercion
An insurance adjuster might use coercion or intimidation to avoid making payments on your policy. An insurance adjuster might suggest that pursuing the claim can result in canceled coverage or increased premiums. An adjuster may discourage a claimant from seeking legal representation by claiming it is unnecessary or harmful.
Improper Investigation of Claims
Not conducting a proper investigation into the facts of the claim can lead to an insurance company making incorrect conclusions about liability or damages. Insurance companies might disregard a victim’s medical records, witness statements, or other important evidence supporting the claimant’s case.
Misrepresentation of Facts or Policies
Insurance companies often misrepresent the facts of the accident or the terms of a policy to avoid making proper payments. Claiming you are partially or fully at fault for the accident without sufficient evidence is a common trick of the insurance company. Misrepresenting what the policy covers or stating certain losses are excluded when they are not is a common pitfall that you should be on the lookout for after an accident.
Offering Lowball Settlements
Offering an accident victim a lowball settlement is one of the tools in the insurance company’s toolbox. Insurance companies want to settle quickly and often before you are done with medical treatment. It is important to review the terms of the settlement with your attorney before you agree to any offer from the insurance company.
Delaying Claim Processing
Insurance companies use tactics to deny or delay claims, such as repeatedly asking for unnecessary or redundant paperwork to stall the process, failing to respond to calls or emails in a timely manner, and delaying payment even after approving a claim.
Unreasonably Denying Claims
Common insurance tactics also include denying claims without a valid explanation, providing vague, unsupported reasons claiming a loss is not covered when it actually is, or interpreting the policy unfairly.
How Can An Attorney Combat Bad Faith Insurance Tactics?
Having an attorney lead you through the claims process is important to the success of your accident claim. An attorney can stand up against the insurance company in the following ways.
- Keep all records of communications, including emails, letters, and phone calls, and share them with your attorney.
- Report any instances of bad faith behavior to your state’s insurance regulator or department of insurance. This process can be difficult, but your attorney can properly file your claim.
- Have an attorney demand written justifications for claim denials or delays from the insurance company.
What Can I Do After a Car Accident Claim Denial?
If an insurance company denies your car accident claim, there are several steps you can take to challenge the denial and potentially secure compensation. Here is a structured approach to what to do after getting a denial from an insurance company.
Review of the Denial Letter
After a claim denial, you will receive a denial letter from the insurance company. Insurance companies must provide a written explanation of why your claim was denied. The reason for the insurance company’s denial will be listed in the letter.
Check Your Policy
Always review the terms of the insurance policy after a denial. Compare the reasons for the denial listed in the denial letter with your insurance policy to ensure the insurer’s interpretation aligns with the coverage terms.
Collect Documentation
You will need accident-related documentation after an insurance denial. Obtain any missing or supplemental evidence that can strengthen your claim, like photos, videos, accident reports, witness statements, medical records, or repair estimates.
Request Clarification From The Insurance Company
You have the right to request clarification from the insurance company after a claim denial. You can call or write to the insurer to clarify the denial and inquire about additional information that can change their decision.
Consult Experts
If applicable, hire accident reconstruction specialists, medical professionals, or repair appraisers to provide expert opinions.
Appeal The Denial
One of your best options after a claim denial is to appeal the denial. Many insurers have an internal appeals process. Submit an appeal in writing, including all supplemental evidence and arguments challenging the denial.
Report Any Bad Faith Practices
Report any bad faith practices you have observed from the insurance company. If you believe the insurer is acting unfairly, file a complaint with your state’s insurance regulator or department of insurance.
Provide Documentation To Your Attorney
Include evidence of your claim, denial, and correspondence with the insurer. Regulators can mediate disputes and hold insurers accountable.
Consult a Lawyer
A personal injury or insurance attorney can review your case, identify bad faith practices, and negotiate with the insurer on your behalf.
File a Lawsuit
Filing a lawsuit might be the only way to recover damages for a claim denial. If negotiations fail, you can sue the insurance company for breach of contract or bad faith. Successful lawsuits may result in compensation for your original claim, emotional distress, and punitive damages.
Explore Alternative Coverage Options
If the at-fault driver’s insurance denies your claim, check if your own insurance can cover the damages. For property damage or injuries, consider alternative sources like health insurance.
How Do I Reduce My Risk of Insurance Claim Denials?
You might want to know how to reduce the risk of an insurance claim denial. Having an attorney is the best way to reduce the risk of a claim denial from the insurance company. Attorneys can present a strong case and negotiate better outcomes.
Other strategies that can minimize your risk include knowing your coverage limits and exclusions, notifying the insurer as soon as possible to avoid delays or disputes, and collecting photos, police reports, medical records, and witness statements.
Always speak to an attorney to learn your options. Having a lawyer is the best way to protect yourself after a car accident and insurance claim denial.
Contact A Car Accident Attorney Today!
You need legal protection after an accident. Discussing your legal options after an insurance claim denial is the best way to ensure you get everything you deserve after a car accident. Do not delay. Contact an attorney in your area after a car insurance claim denial today.