Handling a Denied Car Accident Insurance Claim
Posted on behalf of Lynch Law Firm on Jul 18, 2019 in Car Accidents News
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.
A knowledgeable New Jersey car accident lawyer from our firm is prepared to help you through this process. Contact us to learn more about your legal options during a risk-free consultation. We can determine if it may be possible to build a strong case to overturn the insurance company’s decision.
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
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.
Crash was Preventable so the Victim is at Fault
New Jersey is a no-fault state, which means victims often receive compensation from the no-fault coverage in their own insurance policies. However, if your damages exceed the limits of your insurance policy you may need to seek compensation from the at-fault driver’s policy.
In this scenario, the at-fault driver’s insurance company will be looking for a reason to deny your claim. If you are at fault for the crash, the at-fault driver’s insurer is not liable for your damages.
The insurance adjuster may say your claim is being denied because you could have done more to avoid the accident. An adjuster may also say you did something that helped cause the accident.
The adjuster may have a strong argument if you were arrested for drunk driving or cited for some form of reckless driving (speeding, running a red light, running through a stop sign, violating the right of way, etc.).
However, driving without a license or with an expired tag is usually not a valid reason to deny a claim. Expired licenses or license plates do not have anything to do with the cause of the crash.
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.
Preventing your car insurance policy from lapsing is particularly important in New Jersey because we are a no-fault state. You turn to your own insurance company first to pursue compensation for car crash damages.
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.
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 are probably 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.
A lawyer can review your options to determine if there is other 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. A lawyer may 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.
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 .
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