Car accidents are a fact of life, but they’re also a leading cause of property damage and injury in West Virginia. As such, most drivers carry some form of car insurance.
Unfortunately, it’s not always smooth sailing when filing car accident claims. Sometimes your car insurance company will deny your claim, leaving you to pick up the pieces. But you can obtain what’s yours. In these cases, working with a Wheeling car accident claims attorney is highly recommended. It may not always be necessary to take such drastic measures, but it is wise to have a skilled partner on your side.
What exactly is an insurance claim denial?
Assume you submitted a claim following a car collision that caused thousands of dollars in damages to your vehicle. Because your policy includes auto insurance, you’re confident you’ll be receiving a payout shortly. Instead, you’ll get a letter saying, “We regret to notify you…” that your claim has been refused. Alternatively, you may receive a cheque that covers only a percentage of the damages done to your automobile – significantly less than your deductible.
This scenario depicts the denial of an insurance claim. Your insurance company may deny your claim. Alternatively, if the collision was the responsibility of the other motorist, the claim may be made by their insurer. In any case, it usually means you don’t have enough money to fix your automobile – or, maybe, to pay your medical costs if you were hurt. Your initial reaction is likely to be confusion.
What was the reason for the denial of my claim?
Your insurance company employs people who are known as insurance claims adjusters. Their primary responsibility is to evaluate each submitted accident claim and determine the firm’s legal duty to pay out on claims. The rules and regulations governing insurance requirements change fairly frequently, so it’s critical to understand what recent legislation may apply in your state.
Most claims with recorded damage are admissible, and the claim is generally approved without incident based on witness evidence. However, certain cases are ambiguous, and insurance claims may be denied for numerous reasons. Here are some scenarios why a claim may be denied:
- Your claim exceeds your coverage. For example, if you have $30,000 bodily injury liability coverage and cause $45,000 in medical expenses to the other driver, the extra $15,000 is denied.
- You lack coverage. If you have non-accident related damage and don’t have comprehensive coverage, your claim may be denied.
- Your original insurance application contains errors. You can be denied coverage if you weren’t totally honest on your application or didn’t provide accurate information. Ex: unreported mileage or failing to mention specific vehicle upgrades.
- During your claimable accident, you broke the law. If you were drunk or driving without a license at the time of the accident, your claim might be denied.
- You failed to report the accident. If you do not report the collision to the police and/or your insurer, your claim may be denied. If you develop whiplash two weeks after the accident, your insurer may suspect insurance fraud.
Consider more reasons why your car insurance provider may deny a claim.
- You were involved in an accident with a driver who was not insured.
While the majority of states need liability insurance, not all mandate it for uninsured motorists; if you are engaged in an accident with someone who gives fraudulent insurance information or commits a hit-and-run, obtaining accurate insurance information may be difficult or impossible.
- The insurance of the at-fault driver refused your claim.
When another motorist is deemed at fault, and their vehicle insurance company refuses the claim, there are various possible explanations. Several instances include giving inaccurate insurance information or lacking enough or appropriate coverage.
Similarly, if you are engaged in a crash that was not your fault, you are responsible for your medical bills.
- Your claim was improperly denied.
If an insurance adjuster refuses a claim in bad faith, it indicates that they lacked the necessary basis to make their judgment on the information presented. In this instance, your claim may have been denied incorrectly. While further proof may be required, you do have the option of appealing the claim rejection decision.
- You have a medical condition.
Whiplash is a frequent vehicle collision injury. However, if you have a history of neck discomfort, your insurance company may refuse your personal injury claim. They may also deny you if they believe you had “unnecessary” medical care.
- You delayed seeking medical treatment.
For non-life-threatening injuries, the insurance company may assume you are not wounded if you do not seek medical attention soon after a car accident.
Learn More: WERE YOUR INSURANCE CLAIMS HANDLED IN BAD FAITH?
What steps would you need to take if a claim is rejected or denied by the insurance company?
Car insurance claim rejection appeal
You may appeal a claim denial if you believe the vehicle insurance provider made a mistake. Most insurance companies have a mechanism in place for you to dispute a denied claim. To appeal a car insurance claim judgment, consider these steps:
- Acquire evidence: Examine any insurance company papers and gather proof for your appeal. Police reports, eyewitness statements, photographs and medical records are examples. It is recommended that you retain the originals and make duplicates of everything.
- Write an appeal letter: Outline your reasons for disagreeing with the insurance company’s decision. Explain why you gave each information item in step one, such as police reports. Describe the situation in full, citing the policy and the denial letter as appropriate.
- Immediately contact a car accident lawyer: If you are unsure about following these measures or want an expert’s advice. They may analyze the case and your supporting papers to prepare a demand letter ordering the insurance company to reply and justify its claim rejection. If you believe your claim was wrongfully denied, it may be worth paying to have it reversed
Take advantage of skilled Wheeling insurance bad faith lawyer’s services.
Unfortunately, sometimes insurance companies deny that they owe benefits to their policyholders, even when they have paid their premiums in full.
If your auto accident claims get rejected, you should contact a skilled Wheeling insurance bad faith lawyer as soon as possible. An experienced accident lawyer at Ghaphery Law Offices, PLLC, is ready to help you through the claims process and assist you in negotiating a settlement with the insurance company that is fair and just. If a negotiated settlement cannot be reached, we will file a lawsuit on your behalf.