WHAT CAN I DO IF MY AUTO ACCIDENT CLAIM IS DENIED?

What can you do if your auto accident claim is denied by the other driver’s or even your own insurance company?

You may think that, if you are hurt by another driver’s negligence, their insurance company will pay for your medical costs, treatment, pain and suffering, and other damages caused by the wreck… that’s why people buy insurance, right?

People are often surprised when they attempt to settle their claim with the other driver’s insurance company, only to find that the insurance company is refusing to pay or is offering a settlement that is nowhere near full and fair compensation.

But that’s what insurance companies do – they are not there to pay claims for their insured. Like any business, they are there to make as much money as possible, and they can only do that by denying, delaying, and defending against auto accident claims…

So, your claim was denied. What now?

IF YOUR AUTO ACCIDENT CLAIM IS DENIED, GET AN ATTORNEY

The best advice we can give you is, if you have been injured in an auto accident that was the other driver’s fault, consult with an attorney before you attempt to negotiate with the insurance company.

In most cases, the insurance company will not settle your auto accident claim for its full value. In many cases, they will deny your claim completely until they are contacted by an attorney whom they know will demand full and fair compensation and will take them to trial if they do not pay it.

How can they get away with doing that?

Why Was Your Auto Accident Claim Denied?

It may be that there was a valid reason if your auto accident claim is denied – when you consult with an experienced personal injury attorney, they can advise you as to whether you have a valid claim and what the insurance company’s defenses may be.

On the other hand, the insurance company may be “hanging their hat” on one of many defenses that they ultimately will not be able to prove in your case. Some of the more common defenses, that may be valid or invalid depending on the facts of your case, include:

• The accident was your fault and not the other driver’s – even if the accident was partially your fault, you may still be entitled to compensation. Your attorney will need to evaluate the potential defenses and whether your auto accident claim will be successful – if you are more than 50% at fault in the accident, you cannot recover damages. If jurors find that you are less than 50% at fault, you are still entitled to a partial recovery.
• You had a pre-existing injury or your injuries were sustained after the car wreck – even if you had a pre-existing injury, you are still entitled to compensation if the accident made that pre-existing injury worse, under what is called the “eggshell plaintiff rule.”
• You are faking your injuries, or you are exaggerating your injuries – following up with all medical appointments and advice from your doctors will help your attorney to document the extent of your injuries.
• Lack of evidence – your injuries must be documented in the accident report and medical records, and the documentation must be presented to the insurance company before they will agree to pay your claim.
• Statute of limitations – if your claim is made after the statute of limitations has passed, or if it is so close to the statute of limitations that the adjuster knows you do not have time to consult an attorney before time runs out, they will most likely deny your claim.
• Your claim is more than the other driver’s policy limits – the insurance company will never pay an amount greater than the policy limits. If you have a claim in excess of what is covered, your attorney can settle with that insurance company for their policy limits and also consider whether the other driver has personal assets that could be seized, whether there are any other parties or insurance policies that could pay, or whether your own uninsured or underinsured policy is responsible for part of your claim.

If your auto accident claim is denied, what can your attorney do?

Send a Demand Letter with Documentation

Once you have finished treatment for your injuries and we are sure that we know the extent of the damages owed to you, your attorney may send a detailed demand letter to the insurance company that outlines what happened, includes documentation of your injuries and expenses, and demands payment of full and fair compensation.

They aren’t obligated to respond to a demand letter or pay your attorney’s demand, though. What then?

File a Lawsuit Against the Other Driver

In many cases, your attorney will need to file a lawsuit against the other driver that details what happened, the extent of your injuries, and the specific causes of action that you will prove to a jury if the case goes to trial.

At this point, the insurance company will take your file from the adjuster and give it to their insurance defense lawyers. The defense attorneys may look at the case and recommend that the insurance company pay the claim, or they may drag it out, scheduling depositions and engaging in written discovery before either settling your claim or trying your case to a jury.

Your claim could be settled by the adjuster before a lawsuit is filed, or it could be settled by the insurance defense attorneys at any point before a jury returns their verdict.

Sue the Insurance Company for Bad Faith

Although it is uncommon, in some cases you may be able to sue the insurance company directly for bad faith refusal to pay your claim.

If your insurance company denies a claim in bad faith – without a reasonable basis that could be defended in court, you may be able to sue them for the damages caused by their bad faith denial of your claim and, in some cases, punitive damages.

If the other driver’s insurance company denies your claim in bad faith, your attorney may be able to settle with the other driver by agreeing not to pursue their personal assets in exchange for the assignment of their bad faith claim to you, allowing you to sue their insurance company directly…

GOT AXELROD?

If your auto accident claim is denied by the insurance company, call your personal injury lawyer on the Axelrod team immediately.

Call now at 843-353-3449 or message us on our website for a free case evaluation to determine why your claim was denied and the next steps you should take.