In an ideal world, those who have been hurt in vehicle crashes can do nothing except rest and get well. In reality, however, those who have been hurt also have to deal with money concerns. Having to deal with insurance companies and claim denials is a common occurrence. Victims of automobile accidents sometimes falsely assume that filing an insurance claim would quickly net them the financial relief they need and deserve. But many people are surprised when they learn that their insurance claim has been denied or that the settlement offer falls well short of their actual losses.
Common Reasons for Car Accident Claim Denials
The following are some of the most common explanations for why insurance companies deny claims car accident claims:
Both Drivers Are Liable
It’s crucial for motorists and car owners to fully grasp the coverage provided by their insurance policies. The insurance provider will probably completely deny the claim if a motorist engaged in specific actions that rendered coverage insignificant. In most cases, insurance will be nullified if a driver is caught drinking or texting and driving.
A claim is also likely to be denied if an unlicensed driver was using the covered vehicle with the owner’s agreement and the accident happened. In the end, the insurance company will not pay out a claim if the policyholder has broken any of the conditions of their policy. Insurance companies may disagree about who is responsible for paying damages in the event of an accident if it is unclear which motorist was at fault, even if no crime was involved.
No Medical Examination Was Performed
A motorist should get checked out by a doctor right away following a car crash, even if he or she does not feel hurt. That’s because some wounds won’t show up visually or physically until days or weeks later. Proof of the causal relationship between the car crash and the injuries you suffered may be difficult to establish without an independent medical examination.
Even in the instance of a catastrophic injury, the insurance company may challenge the driver’s claim if the motorist delays getting medical attention and providing documentation to the insurance company. The insurance company may refuse to cover medical expenses if they determine the motorist was not hurt in the collision.
The Claim Exceeds the Policy Limit
Having vehicle insurance that provides enough coverage is necessary for drivers. If a motorist only has $50,000 in insurance on a vehicle worth $100,000 and an accident happens, the driver’s claim may be denied unless they have extra coverage. A claim will be reimbursed up to the limits of the affected driver’s motor policy, or the insurance company may deny the claim entirely if the damages exceed those limitations.
Not Giving Enough Notice to the Insurance Company
Immediately following an accident, policyholders are obligated to contact their insurance provider. If anybody was hurt or killed in an automobile accident, or if more than $1,000 in damage was done, insurance companies in California must be notified within 10 days. It doesn’t matter if there were injuries or deaths; if the insurance company isn’t contacted quickly enough, the insurer might argue it didn’t have enough time to examine the claim while the evidence was still accessible.
The Denial Was Made in Bad Faith
An insurer may be acting in bad faith if they’ve denied your vehicle accident claim without giving you a good explanation. In essence, bad faith refers to when an insurance company wrongfully denies, undervalues, or delays a claim. Insurers who behave in bad faith risk legal repercussions since they have broken the confidence of their policyholders.
If a claim is wrongfully denied by an insurer, bad faith conduct may include deliberately dragging out the claims procedure to the point that the insured is unable to go ahead, or providing an extremely low settlement amount without providing an adequate justification.
Did you know that certain insurance plans only kick in if the insured motorist is behind the wheel when an accident occurs? Let’s say you got into an accident with a teen driver who wasn’t protected by their parent’s car insurance policy. The insurance company could be able to deny your claim in that situation.
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What to Do If Your Insurance Claim Is Denied
If you submitted a first-party claim or a third-party claim, the next stages will be different. In each scenario, though, the first thing to do is to request written explanations for the refusal. A claim denial letter from your insurer is likely already in your possession, but if not, don’t be afraid to request one.
Here are some steps to take if your car accident claim is denied:
- Understand the reason for the claims denial and resubmit your claims.
- Provide additional evidence to back up your claim.
- File an appeal if your request is denied after you have provided all available evidence.
- File a car accident lawsuit against the liable driver.
Present Further Evidence
If the letter of denial states that you failed to submit sufficient proof, it is in your best interest to submit as much of that information as possible. Evidence may consist of photographs taken at the scene, estimates for necessary repairs, or even medical records and invoices.
Consider Submitting an Appeal
If you are unable to provide more proof to support your claim, you may choose to file an appeal or request an assessment from your insurance provider. Your insurance policy should lay out the procedures for you. Follow the steps in the policy and remember to submit everything on time.
Finally, if you’ve exhausted all of your options and feel that nothing else will work, try seeking assistance from others. The insurance commissioner in your state is one possible place to lodge a complaint. In some cases, it may be beneficial to work with a third-party claims adjuster. You should also consider getting help from a lawyer specializing in auto accidents.
In most cases, insurers have less of an interest in providing a reasonable settlement for claims involving third parties. The insurance company owes the majority of its legal duties to the person who is insured under the policy, not to you. If the corporation is being unfair, you may want to consider getting legal representation and filing a case.
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