What to Do If Your Car Insurance Claim is Denied
UPDATED: March 19, 2020
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Just because your car insurance claim is denied after an accident does not mean you abandon your claim and end negotiations with the insurance company. You still have options to pursue the insurance money that you need to pay for your damages and injuries. Your first step is to review your claim denial letter, understand the reasoning used by the company in making its decision, and submit an argument against the denial. The process of appealing an insurance claim denial can be handled without a lawyer, but an insurance attorney can be a valuable asset if the insurance company is particularly resistant to paying the claim.
TIP: If you suffered serious or permanent injuries or extensive damage, or are uncomfortable negotiating your denial, contact an attorney who has experience in auto claims matters.
Why Your Car Insurance Claim Was Denied
Understanding the reasons your car insurance claim was denied is critical to appealing the insurance company’s decision. The insurance company will explain its decision in the car insurance claim denial letter, and you should read through the document thoroughly and understand your insurer’s reasoning. Although claims are denied for a variety of reasons, the most common ones that affect a claim
- Car insurance policy does not cover the accident: Car insurance policies have a variety of different coverage types such as liability coverage or collision coverage. If your accident falls under a type of coverage that you did not purchase, then your claim will be denied. What section of an insurance policy covers an accident can be a judgment call, and you are free to dispute the adjuster’s decision.
- Your coverage has lapsed or you missed a filing deadline: Insurance policies can lapse if you have not paid your premiums, and if your policy is no longer active then you will not be covered. It is also important to keep filing deadlines in mind, and act quickly after your accident. The insurance company will not alert you that you are about to miss a deadline.
- You are not a named party on the insurance policy: Insurance policies only cover individuals who are named in the contract. If you were not on the policy, then you will not be covered.
- The amount of damages exceeds the auto policy limits: Typically, this reason will lead to a limitation on damages rather than an insurance claim denial; however, insurance companies can deny the entire claim.
- You were at fault for the accident: If the insurance adjuster determines that you caused the accident, your claim can be denied depending on your state’s fault laws. When the adjuster determines you are at fault, the claim denial letter must explain why. Take note of the reasons you were considered to be at fault, and compare them with your version of the events and the evidence you gathered.
Reviewing the reasons your car insurance claim was denied gives you the opportunity to compare what the insurance company is saying to the evidence and documentation you presented with your claim.
Appealing a Car Insurance Claim Denial
Car insurance companies typically have a process in place for you to appeal the claim denial, and you can ask your insurance agent or adjuster what steps you need to take to formally dispute the company’s decision. If you decide to appeal an insurance claim denial on your own, you can do so by following a few simple steps:
- Understand why the company denied your accident claim
- Review all the evidence you submitted with the claim
- Write a letter that articulates why the evidence you gathered contradicts the insurance company’s decision. Include copies of the evidence (for example, photographs, eyewitness reports, medical records, police report, diagnostic tests, physical therapy, medications, ), and be sure to connect each piece of evidence to your argument against the adjuster’s decision
- Contact an attorney if you are uncomfortable with disputing the claim on your own.
Insurance companies will not simply reverse the decision to deny a car accident claim because you appeal, but are willing to work with you if your argument makes sense and is well supported by the evidence. If you have been seriously injured or suffered permanent injury or have significant property damage, you might consider consulting with an attorney before entering into negotiations with the insurance carrier.
NOTE: Appealing a car insurance claim denial is not always successful, but you may still pursue the money you need by filing a lawsuit against the other party if s/he was responsible for the accident. An attorney can determine whether there are significant assets held by the other party that can be claimed.
Bad Faith Insurance Claim Denial
If you feel that your insurance company is treating you unfairly by either improperly denying your claim, negotiating in bad faith, or delaying insurance payments, you should hire an attorney. States have laws that protect consumers from bad faith insurance practices, and you may have a legal claim against the company if it refuses to pay out or take reasonable steps to work with you.
An attorney can help you by recognizing bad faith insurance practices, filing a complaint with the state’s insurance commissioner, aggressively negotiating a settlement, or pursuing a lawsuit .