Handling a Denied Car Accident Insurance Claim
Posted on behalf of Lynch Law Firm on July 18, 2019 in Car Accident News. Updated on October 10, 2022
You may have taken all the appropriate steps after a car accident: you reported it to the authorities, sought immediate medical treatment, promptly filed an insurance claim, and reported your damages to the insurance company. But your claim could still be denied.
You may think a denial is the end of the road and accept it. However, many insurance claims are initially rejected and later approved. Many crash victims recover compensation by fighting an insurance company denial, especially if they work with an experienced attorney.
Our knowledgeable New Jersey car accident lawyers are prepared to help you through this process. We are a 5-star rated law firm with the experience to handle accident claims that have been denied.
Contact us to learn more about your legal options during a risk-free consultation. Our attorneys are ready to fight back against the insurance company on your behalf.
WHY DO INSURANCE COMPANIES DENY CAR ACCIDENT CLAIMS?
Insurance companies stay in business by ensuring the premium payments they collect exceed the amount they pay out in claims. Insurance adjusters are incentivized to deny claims as much as possible. They think that many people will not challenge a denial, so they look for any reason to deny the claim.
Some of the reasons often given for a claim denial include:
- Crash was preventable/Victim is at fault
- Policy lapsed
- Crash was not reported in a timely fashion
- Delay in medical treatment
- Damages exceed policy limits
- Driver is not listed on the policy
- At-fault driver is uninsured
- Failure to mitigate damages
- Preexisting condition
- Medical treatment was not reasonable or necessary
- Claim was filed too late
It is important to note insurance adjusters often deny claims in bad faith. They may cite one of the reasons listed above or another reason for denying your claim. However, they may not have solid evidence to back up their decision, which means your claim may have been wrongly denied. If you and your attorney can provide more evidence, you may be able to overturn a denial.
Our experienced attorneys are prepared to thoroughly investigate your accident and gather the necessary evidence to prove your claim. If the insurance company continues to deny your claim, our attorneys are prepared to file a lawsuit on your behalf.
Learn more about common reasons why insurance companies deny claims:
CRASH WAS PREVENTABLE SO THE VICTIM IS AT FAULT
It is important to note that New Jersey is a no-fault state. This means victims often receive compensation from the no-fault coverage in their own insurance policies. Therefore, you may be able to recover some compensation no matter who is responsible for the collision.
However, if your damages exceed the limits of your insurance policy you may need to seek compensation from the at-fault driver’s liability policy. The insurance company is going to try and pin the blame for the crash on the victim. Whether by claiming the person is partially at fault, or by saying he or she could have taken additional action to prevent his or her own damages.
While accident victims do have a duty to mitigate their damages, the insurance company cannot deny your claim for this reason alone. If you were not wearing a seat belt the insurance company may say your injuries would not have occurred if you were wearing a seat belt. However, the insurance company cannot deny your claim entirely for this reason.
Drivers are all expected to take reasonable measures to prevent a collision. Therefore, the insurance company will try to deny your claim by saying that you are partially at fault for the collision because you failed to act in a reasonable manner to prevent the crash. Even if this is accurate, New Jersey allows injury victims who are less than 50 percent at fault to recover a percentage of compensation.
For example, if you are assigned 10 percent of the fault for the collision, and your damages are worth $10,000, you would still be able to recover $9,000 if your claim is successful.
Insurance companies will often claim a victim is at fault when that is not the case. Even if you received a traffic citation, you may not be entirely at fault. If you are not more at fault than the other driver, you can recover compensation under New Jersey’s comparative negligence law.
INSURANCE POLICY LAPSED
This might be a valid reason if the insurance company can prove you missed a premium payment, and your policy was cancelled. That is why it is important to watch for a letter or email about an upcoming deadline for paying your premium and make sure to get it paid. Sometimes you can get a policy reinstated if you are a few days late and prevent a gap in coverage.
It is important to note your insurance company will not tell you if your policy is in a lapsed state. If you are unsure about the status of your policy, give your insurance company a call.
Preventing your car insurance policy from lapsing is particularly important in New Jersey because we are a no-fault state.
CRASH WAS NOT REPORTED TO THE AUTHORITIES FAST ENOUGH
Prompt reporting of a crash to the authorities is vital to the success of your claim. If you do not call the police at the scene or file a report soon after the crash, the insurance adjuster may doubt the truthfulness of the claim. They may claim you are just trying to get money and have not been injured in a car crash.
You may be required to report the crash to the police under New Jersey law. Whenever a crash results in death or injury or more than $500 in property damage, you must report it to the proper authorities.
DELAY IN MEDICAL CARE
Even if you were involved in a crash and you have the police report to prove it, if you waited to seek treatment, the insurance adjuster will assume you were injured because of something besides the crash. They may think: Why would you wait for treatment if you were truly injured?
Even waiting until the day after the crash could make the adjuster suspicious of your intentions for filing a claim. That is why it is best to seek treatment right away.
After a car accident, you may not realize the full extent of your injuries. You may feel a surge of adrenaline that masks the symptoms of an injury. Waiting to seek treatment could allow your injuries to get worse, in addition to affecting your ability to obtain compensation for your damages.
If you sought medical treatment immediately after the accident and have the proof to show it, you will have a stronger case.
DAMAGES EXCEED POLICY LIMITS
Even if the insurance company agrees to pay compensation, the full cost of your damages may exceed the policy limits. Every insurance contract only covers damages up to a certain limit. They may deny liability for the rest of your damages.
Our attorneys are prepared to review your options to determine if there is additional insurance coverage that can help cover your damages, either from your policy or the policy of the at-fault driver or other parties that contributed to the accident.
Additional first-party coverage outside of what is required by law could be helpful in this situation, including underinsured motorist coverage. It is important to review your coverage from time to time to determine if you could afford to purchase more just in case you are injured in an accident.
AT-FAULT DRIVER IS NOT LISTED ON THE POLICY
Sometimes, claims are denied because the driver who was responsible for the accident was not listed on the policy. He or she may be excluded from coverage. Our attorneys can review the contract that applies to your case and see whether the accident should be covered under the policy.
Even if the driver is not listed on the policy, the vehicle owner’s policy may apply if the at-fault driver had permission to use the vehicle. If the at-fault driver is specifically excluded from coverage, the vehicle owner’s policy may be off limits for your claim.
AT-FAULT DRIVER IS UNINSURED
This may not be much of an issue for a New Jersey auto accident claim, as most victims obtain compensation from their own first-party coverage. However, if your damages exceed your policy limits, you may need to seek compensation from the at-fault driver’s insurance.
If the other driver does not have coverage, you may be able to use your uninsured motorist coverage. You never know when you may encounter an uninsured driver, and there are a lot of them on New Jersey roads. It is important to be prepared by purchasing uninsured motorist coverage.
You cannot get compensation for a preexisting injury, but insurance companies often claim a victim has a preexisting injury when that is not the case. You may also be able to obtain compensation if a car accident injury aggravates an existing medical condition. You should not take the insurance company’s word for it that you cannot obtain compensation because of your preexisting injury.
MEDICAL TREATMENT WAS NOT REASONABLE OR NECESSARY
The insurance company is within its rights to deny coverage for treatment you did not need or treatment that was unreasonably expensive. However, insurance companies may claim that treatment recommended by a doctor was unreasonably expensive when that is not true.
Choices about medical treatment are up to you. However, if you decide to get treatment that you think will help you, but it was not medically necessary, you need to be aware you may need to pay for it yourself.
If the insurance company claims treatment recommended by your doctor was unnecessary, your attorney can challenge this assertion.
CLAIM WAS FILED LATE
The insurance company may have a deadline for filing a claim, which is why it is important to contact an attorney right away so he or she can file a claim on your behalf. If the insurance company is telling you it is too late to file a claim, you should still consider talking to an attorney to learn if you can still seek compensation.
HOW TO FIGHT A CLAIMS DISPUTE
If your claim was wrongly denied, one of the most important things you can do is contact an experienced lawyer. He or she can review your options and appeal a denial if you have a valid case. Your lawyer may be able to obtain more evidence to strengthen your claim. Insurance companies often act in bad faith.
REVIEWING THE DENIAL LETTER
One of the first steps in disputing a denied claim is to review the insurance company’s denial letter. That way your attorney can understand exactly why your claim was denied and the reasoning behind the decision. This should give your attorney an idea about the information he or she will need to challenge the insurance company’s decision.
The insurance company may have cited something from the police report that is untrue. Your attorney should be able to get police report errors corrected. He or she can also gather other evidence:
- Updated medical records
- Eyewitness statements
- Other evidence from the scene
APPEALING THE DECISION
The next step is to make an appeal to the insurance company to reconsider your claim. This is often done via an appeal letter. Each state has its own procedures for appealing an insurance claim denial.
The letter explains why you disagree with the denial and argues against the reasoning for the denial, citing evidence that is provided with the letter.
CONTACT US FOR LEGAL HELP AFTER A CLAIM DENIAL
When your insurance claim is denied, it is important that you have legal support. An experienced attorney from the Lynch Law Firm is prepared to review the reason for your denial and work to overturn it. We can manage the investigation and negotiations on your behalf, as we have a proven track record of success.
The attorneys at Lynch Law Firm work on a contingency fee basis, which means there are no upfront costs involved for our legal services unless you obtain compensation for your case.
Schedule a free, no-obligation case evaluation. Call (800) 518-0508 .