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Your Car Insurance Claim Was Denied. Now What? A Texas Attorney’s Complete Guide
If your car insurance claim is denied, the sudden weight of financial responsibility for repairing your vehicle and paying mounting medical bills can feel crushing. There are very few experiences more stressful than a car accident and the complex claims process that follows, especially when you’re injured. The last thing you need added to your physical pain and emotional distress is an insurance company giving you the runaround, delaying, or outright denying the compensation you need to recover. At Attorney911, with over 25 years of experience fighting insurance companies across Texas, we’ve seen this scenario play out thousands of times. This comprehensive guide, written from our perspective as senior litigation attorneys, will explain why claims are denied, your legal rights under Texas law, and the exact steps you must take to fight back. Call our legal emergency line at 1-888-ATTY-911 for immediate guidance if you’ve received a denial letter.
Understanding the Insurance Company’s Right to Deny Claims in Texas
The transcript from our video correctly states a harsh reality: insurance companies have the right to deny claims, and they exercise this right strategically to protect their bottom line. When you file a claim after a motor vehicle accident in Houston, Austin, Beaumont, or anywhere in Texas, you’re hoping the insurer provides a full and fair settlement that compensates you for your injuries, vehicle damage, lost wages, and pain and suffering. However, insurers are for-profit corporations. Their adjusters are trained to minimize payouts, and denial is one of their most powerful tools. As Ralph Manginello, founder of Attorney911 and a Texas attorney admitted to practice in 1998, explains: “Insurance companies bank on policyholders not understanding their own policies or state law. They use confusing language and procedural hurdles to wear people down, hoping they’ll either accept a lowball offer or give up entirely.”
It’s critical to understand the different claims scenarios. If you were hit by another driver in Texas, you generally file a third-party claim against the at-fault driver’s liability insurance. If you were at fault or need to cover your own vehicle repairs through collision coverage, you file a first-party claim with your own insurer. Each scenario involves different policy language, legal duties, and potential for dispute. Furthermore, Texas operates under a “fault” system for car accidents, meaning the driver who caused the accident (or their insurer) is financially responsible for the damages. This is governed by the Texas Transportation Code and relevant insurance regulations.
Why Immediate Legal Consultation is Critical After a Denial
The moment you receive a denial—or even a lowball offer that feels like a denial—the clock starts ticking on critical deadlines. Texas has a strict two-year statute of limitations for personal injury lawsuits (Texas Civil Practice & Remedies Code § 16.003). More immediately, evidence disappears daily. Surveillance footage from nearby businesses is typically overwritten in 7 to 30 days. Witness memories fade. The physical evidence at the accident scene changes. Insurance companies begin building their defense case against you from day one. Having a former insurance defense attorney on your side, like our own Lupe Peña, means we know their playbook because we used to run it. Lupe spent years at a national defense firm, learning exactly how large insurers value claims, which arguments they use to deny them, and how they pressure injured Texans into accepting less. Now, he uses that insider knowledge exclusively for our clients. Don’t face this alone. Call 1-888-ATTY-911 for a free, no-obligation review of your denial letter.
Five Common Reasons Insurance Adjusters Deny Car Accident Claims in Texas
Based on our decades of litigation experience across Texas courts, including the U.S. District Court for the Southern District of Texas, we see the same denial reasons repeatedly. Understanding these tactics is your first step toward countering them.
1. Lack of Merit or Disputing Fault
The adjuster may claim they “don’t believe you” or assert that the accident was your fault. They might argue the impact wasn’t severe enough to cause your injuries, that you were partially (or wholly) responsible, or that your medical treatment was excessive. This is a classic tactic to shift blame and reduce their liability. Under Texas’ modified comparative fault rule (Texas Civil Practice & Remedies Code § 33.001), you can still recover damages if you are found to be 50% or less at fault. However, your recovery is reduced by your percentage of responsibility. If you are found 51% or more at fault, you are barred from recovery. Insurance adjusters will often allege a high percentage of fault against you to pressure a lower settlement or justify a denial.
Attorney911’s Approach: We don’t accept an adjuster’s opinion as fact. We immediately launch our own investigation. We obtain the police report, hire accident reconstruction experts if necessary, interview witnesses, and gather photo and video evidence. Our experience in complex litigation, such as the BP Texas City explosion cases, has taught us how to build irrefutable evidence chains. As client Jamin Marroquin noted, “Mr. Manginello guided me through the whole process with great expertise.” We prove the mechanics of the crash and directly link them to your documented injuries.
2. Policy Exclusions and Coverage Limits
Insurance policies are filled with exclusions and limitations. An adjuster may deny a claim because the at-fault driver was an “excluded driver” on the policy, the specific type of accident isn’t covered (like the “acts of God” example in the transcript), or the policy had lapsed due to non-payment. Texas law requires minimum liability coverage of $30,000 per injured person, $60,000 per accident, and $25,000 for property damage (often called 30/60/25 coverage), but many drivers carry only these minimums.
Attorney911’s Insider Knowledge: Lupe Peña’s background in insurance defense means he understands policy language intricacies better than most plaintiff attorneys. We meticulously review the relevant policies to identify all potential sources of coverage, including umbrella policies, business coverage if the driver was working, and underinsured motorist (UIM) coverage under your own policy. In one case, our investigation revealed that a client injured by a logging truck had multiple avenues for recovery beyond the driver’s policy, leading to a multi-million dollar settlement for his brain injury.
3. Late Reporting of the Accident or Injuries
Insurers demand prompt notice. If you didn’t immediately call the police, seek medical attention, or notify the insurance company, they will use this delay against you. They’ll argue that the gap in time suggests your injuries aren’t serious or aren’t related to the accident. They may even raise suspicions of fraud. Most Texas auto policies have a “prompt notice” clause, and while courts often require the insurer to show they were prejudiced by the delay, it’s a battle you don’t want to fight alone.
Attorney911’s Guidance: Even if you delayed, don’t assume your claim is dead. We help clients like Donald Wilcox, who came to us after another firm rejected his case. “I got a call from Manginello…I got a call to come pick up this handsome check,” he said. We gather evidence to explain the delay—perhaps you were in shock, your symptoms were delayed (common with soft-tissue injuries or TBIs), or you were focused on emergency care for a family member. We build a medical timeline that connects your treatment directly to the crash.
4. Your Claim Exceeds the At-Fault Driver’s Policy Limits
This is a devastatingly common scenario in Texas, where minimum coverage limits are low. If the at-fault driver has only $30,000 in bodily injury liability coverage and your medical bills total $45,000, the insurer will deny the excess $15,000. They have no contractual obligation to pay beyond their policy limits. Your recovery then depends on pursuing an underinsured motorist (UIM) claim under your own policy or pursuing the at-fault driver’s personal assets, which are often minimal.
Attorney911’s Strategy for Maximum Recovery: We aggressively pursue every available dollar. This includes filing a UIM claim with your own insurer—a process that can become adversarial, as your own company now has a financial incentive to minimize your claim. We also conduct thorough asset checks on the at-fault driver. In cases involving severe injuries like amputations or wrongful death, we explore all avenues, including claims against employers under the doctrine of respondeat superior if the driver was working, or against bar owners under dram shop liability (Texas Alcoholic Beverage Code § 2.02). Our trucking accident attorneys have recovered millions for families in wrongful death cases by looking beyond the truck driver to the trucking company, maintenance contractors, and cargo loaders.
5. You Were Driving Illegally at the Time of the Accident
If you were violating the law—such as driving under the influence (DUI/DWI) or on a suspended license—the insurance company may deny your claim, even if the other party was primarily at fault. They may argue that your illegal activity constitutes a breach of the policy’s “cooperation” clause or a violation of public policy.
Attorney911’s Dual Expertise: This is where our unique combination of top-tier personal injury and criminal defense expertise becomes invaluable. If you’re facing criminal charges from the accident, Ralph Manginello’s membership in the elite Harris County Criminal Lawyers Association (HCCLA) and his track record of getting DWI charges dismissed (like in cases where breathalyzer maintenance logs were faulty or video evidence contradicted police testimony) can protect your freedom and your civil claim. We handle the criminal and civil cases in tandem, ensuring defense strategies in one court don’t undermine your injury claim in another. As client Cassie Wright attested, “Ralph is an AMAZING ATTORNEY. I have used him 2 TIMES FOR 2 separate cases… He gets the JOB DONE RIGHT!!!!”
What to Do If Your Texas Auto Insurance Claim Is Wrongfully Denied: A Step-by-Step Action Plan
As the transcript emphasizes, a wrongful denial is not the end. You have powerful rights under Texas law and your insurance policy. Here is your action plan, informed by our 25+ years of forcing insurance companies to reverse course.
Step 1: Secure and Scrutinize the Formal Denial Letter
Do not rely on a phone call. Demand a written denial letter that cites the specific policy provisions or factual reasons for the denial. Texas law often requires this. Under the guidance of our attorneys, we review this letter line by line. We compare their stated reasons against the actual policy language and the facts of your case. Often, we find misinterpretations or misapplications of policy exclusions.
Step 2: Build Your Appeal with a Powerful Evidence File
Do not simply write an angry letter. Write a comprehensive, evidence-based rebuttal. This should include:
- A clear timeline of the accident and your immediate actions.
- The official Texas Peace Officer’s Crash Report (police report).
- All medical records, bills, and a narrative from your doctor linking your injuries to the crash.
- Photographs of vehicle damage, injuries, and the scene.
- Witness statements and contact information.
- Expert opinions, if already obtained (e.g., a biomechanical engineer on injury causation).
As Lupe Peña advises, “Assume every piece of paper you send will be scrutinized by a defense attorney. Make your appeal bulletproof from the start.”
Step 3: File a Formal Complaint with the Texas Department of Insurance (TDI)
The TDI regulates insurance companies in Texas. You can submit a formal complaint detailing the wrongful denial. While the TDI cannot force an insurer to pay a specific amount, it can investigate for pattern of bad faith practices and regulatory violations. A TDI inquiry often prompts a more serious review from the insurance company’s legal department. We help clients navigate this process efficiently.
Step 4: Prepare for Litigation—Sue for Bad Faith, Breach of Contract, or Personal Injury
If the appeal fails, your final and most powerful option is to file a lawsuit. You have multiple potential claims:
- Breach of Contract: For violating the terms of your own policy (in a first-party claim) or the at-fault driver’s policy (in a third-party claim where you are a third-party beneficiary).
- Bad Faith Insurance Practices: Under the Texas Insurance Code and common law, insurers owe a duty of good faith and fair dealing. Unreasonably denying a valid claim, failing to properly investigate, or misrepresenting policy terms can constitute bad faith. Successful bad faith claims can result in recovery of your actual damages plus additional penalties, including up to three times your actual damages and attorney’s fees under the Texas Insurance Code.
- Personal Injury Lawsuit: The underlying lawsuit against the at-fault driver. This is the core action to recover compensation for your medical expenses, lost wages, pain and suffering, and disfigurement.
At Attorney911, we prepare every case as if it’s going to trial from day one. Insurance companies know which firms are willing to go the distance. Our history of taking on massive corporations in the BP explosion litigation and our current pursuit of a $10 million lawsuit against the University of Houston and Pi Kappa Phi fraternity (Bermudez v. Pi Kappa Phi Fraternity, Inc.) signals that we are not a settlement mill. We try cases. This reputation forces insurers to offer more realistic settlements earlier in the process. If you’re ready to fight, call 1-888-ATTY-911.
Why You Absolutely Need a Texas Car Accident Lawyer After a Denial
The transcript is unequivocal: if your claim is denied, consult a lawyer immediately. Here’s why Attorney911 is the definitive choice for Texans facing this fight.
We Know the Insurance Playbook Because We Wrote It
Our firm’s unique advantage is Lupe Peña’s insurance defense background. He knows how adjusters are trained, how claims are valued using software like Colossus, how IME (Independent Medical Exam) doctors are selected to downplay injuries, and how surveillance is used. “I’ve reviewed hundreds of surveillance videos as a defense attorney,” Lupe says. “They take innocent activity out of context. We know how to counter these tactics and present your full, truthful story to a jury.” This insider knowledge is an unfair advantage we wield for our clients.
We Have a Proven Record of Multi-Million Dollar Results
We don’t just make promises; we have documented results. Our firm has secured multi-million dollar settlements for clients with catastrophic injuries, such as a brain injury with vision loss from a logging accident and a car accident case involving a partial leg amputation due to post-accident infection. We’ve recovered significant sums for maritime back injuries and wrongful death from trucking accidents. These results demonstrate our ability to properly value severe, life-altering injuries and fight for every dollar necessary for our clients’ futures.
We Offer Compassionate, Communicative Representation You Can Trust
Read our 251+ Google reviews with a 4.9-star rating. Clients constantly praise our communication and personal care. Paralegal Leonor (“Leo”) is mentioned over 80 times for keeping clients informed and supported. As client Chad Harris said, “You are NOT a pest to them and you are NOT just some client…You are FAMILY to them.” We have bilingual staff, including Zulema, and Lupe Peña is a fluent Spanish speaker, ensuring no language barrier prevents you from understanding your case.
We Operate on a Contingency Fee Basis—No Recovery, No Fee
You pay nothing upfront. We advance all case costs, from filing fees to expert witness expenses. Our fee is a percentage of the recovery we secure for you (33.33% before trial, 40% if the case goes to trial). If we don’t win, you owe us nothing. This aligns our success completely with yours. We only get paid when you do.
We Are Texas-Focused, with Deep Roots and Statewide Reach
Ralph Manginello was raised in Houston’s Memorial area and has practiced in Texas courts for over 25 years. Lupe Peña is a third-generation Texan from Sugar Land. We serve clients across the state from offices in Houston, Austin, and Beaumont. Our knowledge of local court rules, judges, and opposing counsel is a tactical advantage. Even Houston legend Trae Tha Truth has recommended our firm, a testament to our standing in the community.
Don’t let an insurance denial be the final word on your recovery. You have the right to fight back with a legal team that has the experience, insider knowledge, and proven results to win. Contact the Legal Emergency Lawyers™ at Attorney911 today. Call 1-888-ATTY-911 or visit attorney911.com for your free, immediate case review. Let us turn your denial into a victory.
Frequently Asked Questions: Denied Car Insurance Claims in Texas
How long do I have to appeal a denied car insurance claim in Texas?
While your insurance policy may specify a time limit for an internal appeal (often 30-60 days), your broader legal deadline is the two-year statute of limitations for personal injury lawsuits. However, you should act immediately. Evidence deteriorates, and starting the appeal process quickly shows the insurer you are serious. Call Attorney911 at 1-888-ATTY-911 as soon as you receive the denial to protect all your options.
Can I sue my own insurance company in Texas?
Yes, absolutely. If your own insurance company (e.g., for underinsured motorist, collision, or Personal Injury Protection coverage) wrongfully denies your claim or acts in bad faith, you can file a lawsuit against them for breach of contract and/or violations of the Texas Insurance Code. These are known as “first-party bad faith” claims and are a core part of our practice at Attorney911.
What if the insurance company says I’m 50% at fault?
Under Texas’ modified comparative fault rule (51% bar rule), if you are found 50% or less at fault, you can still recover damages, but your compensation will be reduced by your percentage of fault. For example, if a jury awards you $100,000 but finds you 40% at fault, you would receive $60,000. An insurance adjuster’s initial fault assessment is just an opening argument. We work to prove the other driver’s greater fault through evidence and expert analysis.
What evidence is most important to overturn a denial?
The police report, contemporaneous medical records showing immediate treatment, photographs of vehicle damage and injuries, and witness statements are foundational. For disputing fault, an accident reconstruction expert can be crucial. For disputing injury causation, a treating physician’s detailed narrative report is vital. Our team at Attorney911 knows how to quickly gather and organize this evidence to build an irresistible case.
Will my case go to court if I hire Attorney911?
While the vast majority of cases settle before a trial, we prepare every single case as if it will be tried before a Texas jury. This preparation is what gives us leverage in negotiations. Insurance companies know when a firm is willing and able to go to trial—and we have the federal court experience and multi-million dollar verdicts to prove we are. Our readiness for court is what often forces a fair settlement.
What if I can’t afford medical treatment while my claim is disputed?
We can help connect you with medical providers in our network who understand the personal injury claims process and are willing to provide treatment on a lien basis. This means they wait for payment until your case settles or wins at trial. You get the care you need now without upfront out-of-pocket costs. This is a critical service we provide to our clients during the fight.
Frequently Asked Questions
How long do I have to appeal a denied car insurance claim in Texas?
You must act quickly. While policy internal appeals may have short deadlines (30-60 days), your ultimate deadline is Texas’ two-year statute of limitations for filing a personal injury lawsuit. However, evidence fades fast, so contacting an attorney immediately is critical to protect your rights and build the strongest appeal.
Can I sue my own insurance company for denying my claim?
Yes. If your own insurer (for UM/UIM, collision, or PIP coverage) wrongfully denies your claim or fails to act in good faith, you can file a lawsuit for breach of contract and violations of the Texas Insurance Code. These “first-party bad faith” claims can recover your damages plus potential penalties.
What if the insurance company says the accident was partly my fault?
Texas uses a modified comparative fault system (51% bar rule). If you are found 50% or less responsible, you can still recover damages, reduced by your percentage of fault. An adjuster’s initial fault determination is not final. We gather evidence to minimize your assigned fault and maximize your recovery.
What makes Attorney911 different from other personal injury firms?
Our key advantage is insider knowledge. Associate Attorney Lupe Peña spent years as an insurance defense attorney, learning exactly how companies value and deny claims. We combine this with Ralph Manginello’s 25+ years of trial experience, a track record of multi-million dollar results, and a commitment to preparing every case for trial, which forces better settlements.
What if I can’t afford a lawyer to fight the denial?
We work on a contingency fee basis: you pay nothing unless we win your case. We advance all costs. Our fee is a percentage of the recovery we secure. This ensures access to justice for all injured Texans, regardless of their current financial situation.
What should I do immediately after receiving a denial letter?
1) Do not cash any lowball settlement check from the insurer. 2) Call Attorney911 at 1-888-ATTY-911 for a free case review. 3) Gather all related documents (policy, denial letter, medical records, crash report). 4) Stop discussing your case with the insurance adjuster. Let our attorneys handle all communication from that point forward.
