Nearly every state requires drivers to have car insurance. Car insurance is required in almost every state. However, most drivers and car owners purchase it to meet the law.
You might file a claim with either your own insurance (a “first-party claims”) or another’s (“third-party claims”) after an accident. It doesn’t matter what company you deal with, it will frustrate you if they deny or try to underpay your claim. This is especially true if your insurer denies your claim after paying monthly premiums for many years, or even decades.
We’ll break it down in this article:
- There are reasons claims are denied or not paid
- How to respond if your claim is denied
- What to do if you suspect an insurance adjuster is acting with bad faith
Reasons Claims are Denied or Underpaid
Car accidents can be stressful. You may be hurt yourself. You may feel guilty for injuring another person, whether they are a pedestrian, a driver, or a passenger. It is possible to be concerned about getting to work from the shop while your car is being repaired. You don’t want to bargain with insurance adjusters.
You need to know why an adjuster denies a part of your claim. Common disputes include:
- Coverage. Did the policy cover the accident-caused person?
- Liability. Who was responsible for the car accident Did you share the blame ?
- Delay Filing. Did the claim get filed within the deadlines set by the policy Third-party claims are usually not subject to time limits. Although first-party claims may not have time limits, insurers will usually need to prove that the delay in filing the claim negatively affected (prejudiced), the company’s ability and resources to investigate it.
- Refusal to treat. Do you wait to see a doctor for medical attention or did you seek treatment immediately? Do you have medical records that prove your injuries?
- Preexisting condition. Did you sustain injuries at the time of the accident or were you suffering from a preexisting condition?
- Policy lapses. Are your premiums current? Is the policy currently in force?
- Intentional misconduct. Are you under the influence of alcohol and drugs while driving? Your insurer may deny coverage if you are found to be under the influence of alcohol or drugs. Find out more about DUI-related injuries and car insurance.
- Policy limits. Are you able to make a claim that is greater than the policy limits of your insured? (A policy limit refers to the maximum amount an insurer will pay under a policy. Some states may require very little coverage.
How to handle a denied car insurance claim
Your case is not closed just because an insurer denied part of it. Consider the denial of your claim as a point of departure for negotiations.
Ask the adjuster for a written explanation as to why the claim was denied. Ask the adjuster for a written explanation of the reason why your claim was denied. This should include policy limits. Ask the adjuster what statutes, rules or regulations he is using to deny you a claim.
Write your own letter to confirm your request and to deny the refusal of the adjuster if he refuses. It might be necessary if you want to go above and beyond the adjuster or to court.
This post was written by Kelly-Ann Jenkins of Jenkins Law P.L. Kelly-Ann is a car accident attorney in St Petersburg. She focuses on personal injury, car accidents, and bicyclist injury. The information on this site is not intended to and does not offer legal advice, legal recommendations or legal representation on any matter. Hiring an attorney is an important decision, which should not be based on advertising. You need to consult an attorney for legal advice regarding your individual situation.
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