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Why Won't the Insurance Company Pay My Auto Accident Claim?

Our goal in auto accident cases is to get full compensation for every element of damages that our client is entitled to receive.

The insurance company's goal is exactly the opposite. They want to pay the least amount possible and they will look for every excuse to deny your claim, pay less than your claim is worth, or delay paying your claim for as long as possible.

What are some of the reasons insurance companies give for not paying your claims? If they try to limit or deny a claim, can't we just go after the defendant and make him or her pay for the damages?

Reasons Insurance Companies Give for Not Paying Your Auto Accident Claim

There are many reasons for an insurance company to deny or reduce a claim. Some of them are valid legally, but many are just excuses and tactics that insurance companies use to save money.

Your Injuries are Fake or Exaggerated

There are many variations of this defense. The general idea is that, even though their insured driver may have been at fault, you are not hurt as badly as you claim and therefore they should have to pay less money. Some examples include:

  • Your injuries were pre-existing. The insurance company may try to not pay your claim or pay less money by claiming that your pain is the result of a pre-existing injury from a prior accident or illness. The truth may be: 1) The pre-existing injury has nothing to do with the current injury; or 2) The current injury has made the pre-existing injury worse in which case the defendant must compensate you for the damage that was caused. This is called the "eggshell plaintiff" rule.
  • You did not claim to be in pain at the accident site or you did not immediately seek treatment for an injury. Although insurance companies will use this as an excuse to not pay or to offer to pay a lower amount, they know that there are many types of injuries, such as soft-tissue neck and back injuries, that do not manifest until days or even weeks after an accident occurs.
  • You over-treated for your injuries. Only your doctor or another medical professional can tell you what treatment is needed for a full recovery from your injuries, not an insurance adjuster.

The Accident was Your Fault

Insurance companies will also look for any way to say that the accident was your fault and not the fault of their insured. They know that if you are more than 50% negligent under South Carolina's comparative negligence law they will not have to pay anything.

They also know that any percentage of negligence that they can attribute to you up to 50% will reduce the amount of damages that they must pay. Some examples include:

  • You were not wearing a seatbelt. You are not necessarily barred from recovery simply because you failed to use a seatbelt, although it may diminish your recovery under the theory of comparative negligence.
  • You were speeding, failed to use your traffic signal, or you violated another traffic law. It is true that you may be barred from recovery if the accident was truly your fault based on a traffic violation. It may also be true that you are entitled to partial recovery under the theory of comparative negligence or full recovery if your traffic infraction did not contribute to the accident.
  • You stopped too quickly causing the other driver to collide with your car from behind. Although insurance companies will use this as an excuse from time to time, it is laughable and does not bar you from recovering full compensation. All drivers are expected to leave a reasonable amount of space in between vehicles and to anticipate sudden stops from the vehicle in front of them. If another driver collides with your car from behind, they are most likely going to be 100% at fault for the accident.

The common thread in most of these insurance company excuses is the allegation that you are lying and therefore: 1) You are not entitled to any recovery; or 2) You are only entitled to a reduced recovery.

Your auto accident lawyer at Axelrod and Associates has heard it before, understands the law of liability and comparative negligence in auto accident cases, and will fight to ensure that you are paid full compensation for your injuries.

Who pays the settlement or verdict for your car accident?

You could file a personal injury lawsuit, but you don't want to hurt the guy who hit you. It really was an accident, and he clearly doesn't have a lot of money. Will a lawsuit make his life even harder?

No. Although a personal injury defendant can be forced to pay if they have the resources, in most cases their insurance company, or a combination of insurance policies, will pay the bill.

Although the at-fault driver is named as the defendant in an auto accident lawsuit, their insurance company is obligated to provide them with a defense lawyer and to pay any settlement or verdict up to their policy limits.

The Defendant Usually Does Not Pay Because That's Why We Have Insurance Policies

Some people cringe when it comes to filing a personal injury lawsuit. I have a friend who likes to say, "I don't believe in suing, on principle."

Here's the thing - if everyone thought like that, insurance companies would make even more money (and they already make a lot of money), they would have even less incentive to pay claims, and millions of drivers would pay out of pocket for repairs and medical care that the insurance companies are supposed to pay for.

That's why you pay insurance premiums - so that if you run into sudden costs resulting from a car accident, you don't have to go broke paying them. That's why the at-fault driver was paying their insurance premiums.

If you decide not to file suit because you don't want to hurt the other driver, you are not helping the other driver - you are only helping the insurance company maximize their profits at your own expense.

Won't the Driver's Premiums Go Up After a Lawsuit?

The at-fault driver's premiums will go up as soon as the insurance company knows they caused an accident - which has already happened before you even start thinking about filing a personal injury claim. In some cases, the insurance company will completely drop the at-fault driver as a customer as soon as they find out about the accident.

That driver will not have to pay more if you go ahead with your PI claim - the insurance company will. From a public policy perspective, it's the sole reason that insurance companies exist...

What If the Other Driver Doesn't Have Insurance?

So, what if the at-fault driver didn't have any insurance? Or, what if it was a hit and run accident?

Talk to your SC PI lawyer immediately - don't assume that there is no coverage. In some cases, your own underinsured or uninsured policy will cover all or part of the damages. In other cases, your attorney may be able to identify other sources of recovery or work with law enforcement to identify the hit and run driver.

Got Axelrod?

If you or someone you know has been injured in an auto accident, schedule a free consultation with a Myrtle Beach personal injury lawyer on the Axelrod team. Call us at (843) 916-9300 or fill out our contact form today.

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Axelrod & Associates, P.A.
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