What Happens If Your Insurance Claim Is Denied?
July 28, 2021

What Happens If Your Insurance Claim Is Denied?

So you've been injured in a vehicular accident. You're almost certain that the other driver was responsible, so you with their insurance company. Sadly, the insurance company refuses to pay, and they deny your claim, which leaves you paying the bill and suffering the traumatic event considerably longer than expected.

So why would an insurance company deny a claim after an accident? Can one make their claim more persuasive than the insurance company? Are there other options in the event the insurance claim is denied? How did the aftermath of the accident become worse to navigate than the accident itself?

However, if one can understand when, how, and why their claim has been denied, it's possible to receive the compensation you deserve after an accident. That's right, there's still hope in such a difficult situation.

Why Insurance Companies Deny Claims 

In the event another driver is responsible for a crash, you have a right to compensation. When the other driver has car insurance, contacting their insurer is usually the first step victims take. Sadly, most insurance companies will not approve every claim. Why? Because insurance companies deny such claims frequently for various reasons. Such reasons are due to:

Bad Faith

Whenever a driver signs up for insurance, they'll sign a contract with the insurance company. The insurance company has an obligation to act in good faith in the event benefits are requested. This also includes a third-party claim that has been sent by a victim. So what does this mean? The insurance company in question must utilize due diligence and take notice of your claim. Your claim must be:
  - Processed timely
  - Investigated in detail
  - Have approval from an insurance adjuster

After being carefully considered, an insurance company retains the right to deny a claim. However, the insurance company is required to offer a reasonable and legitimate reason for the denial.

The reason for this is due to the fact that bad faith practices do happen. Insurance companies have long developed techniques that make it easier to skirt the law. Some insurance companies even go as far as denying claims without processing their merits. Some insurance companies will even delay processing so the victim will become eager to settle or nervous. Some have even gone as far as ignoring the responsibility of investigating completely.

The Claim Wasn't Submitted on Time

Many insurance companies have no hard-and-fast deadline for an individual to claim after an accident has occurred. Sadly, insurance companies reserve a right to deny a claim if it hasn't been submitted within a reasonable time frame after an accident has taken place. So what is reasonable? This depends on the insurance company and what insurance policy the other driver has. Certain scenarios require filing days after the accident as some allow weeks to file.

There's No Insurance

The insurance company will have no problem denying claims in the event it is determined that there was no coverage when the accident occurred. The insurance company is absolutely going to analyze the driver's policy to be certain that it was fact valid in the event you were injured. If the driver didn't pay their premiums on time, they have no coverage, or their policy was void are all reasons why an insurance company shut down your claim. Long story short, the insurance company will refuse to honor such claims if the policy has lapsed.

The Damage Was Excluded

Vehicle insurance companies are only willing to pay for damage covered by the policy of the at-fault driver. However, exclusions are what insurance companies will refuse to cover. For example: damage caused by severe weather is often turned down by insurance companies. So, given these situations, most car insurance agencies will only cover direct damage.

Named Driver Exclusions

"Named Driver Exclusions" means that the vehicle is insured, but the damage created by certain drivers will not be covered. In the event you are struck by such a driver on this list, the insurance company in question can deny your claim.

Disputed Liability

In the event you submit an insurance claim, one will have to provide detailed accounts regarding the accident and anything that can support their claim. Once the demand letter is received, the insurance company will investigate the accident to determine if your claim is valid. If any evidence exists that the driver at fault wasn't responsible for the accident, the insurance company is likely to deny any requested benefits.

Strengthening Insurance Claims

Some ways one can strengthen their car insurance claim would be:
  - Offering statements from witnesses for claim verification.
  - Drafting a letter detailing why the accident occurred and why the other driver was responsible for it.
  - Provide a copy of the accident report from the police.
  - Mark down any citations that the other driver was issued after the accident.
  - Include medical evaluations and records so that your injuries in the crash can be linked together.
  - Take photographs that document your injuries, where the accident took place, and damage to the vehicles.

Considering the information above, a rejected claim can be heartbreaking. Thankfully, we're here in the event you need a skilled bad faith attorney. Contact us today for further information!