What to Do if Your Car Insurance Claim Is Denied

If your car insurance claim is denied, you might be worried that you’ll be stuck fixing your own car and paying for your medical expenses out of your own pocket. There are very few things that are more stressful than a car accident and the claims process that follows, especially if you are injured. The last thing you need to add to your headache is the insurance company giving you the runaround. 

Here at Attorney911, we’ve been helping people deal with insurance claim denials and auto insurance companies for 20 years. Many of our clients come to us after their claims are denied and ask us what to do next. So what should you do if your car insurance claim is denied?  Here is a guide.

Can my car insurance deny my claim after an accident?

Insurance companies have the right to deny claims and they take advantage of that right whenever they can.  If you were hit by someone else, you can file a claim against the responsible party’s insurance.  If you hit someone then you will need to file your property damage claim with your own insurance and if you were injured – ask them what coverage you have to cover your injuries. When you file a claim after a motor vehicle accident, you’re hoping that the insurance company gives you a full and fair settlement that compensates you for the injuries and damages you suffered from the accident. 

Unfortunately, these things don’t always go as smoothly as they should. The insurance claims adjuster may deny your claim for no reason, or they may offer you a low settlement that doesn’t cover your expenses. Many people are shocked when they receive a denial, especially when they feel like it should be an open-and-shut case. Insurance companies love to make up excuses to deny or minimize your claim. They’re for-profit businesses, and paying you less is how they make more. 

Here are a few examples of common reasons a claims adjuster might deny your car accident claims:

Lack of Merit

An adjuster might deny your claim because they don’t believe you and will say you were at fault.  They may say the hit wasn’t hard enough to cause any injuries.  They may say that you were 50% responsible for the accident.  The insurance adjuster may also think you are not as injured as you claim to be or that some of your medical expenses were unnecessary.  Don’t let the insurance companies push you around.  We fight for people like you everyday.  

Policy Exclusions

Insurance policies place limits on the situations for which they have to pay you.  Sometimes the driver that hit you is an excluded driver on the policy.  Or here is an extreme example, if the at-fault driver’s insurance company does not offer coverage for “acts of God,” the claims adjuster might deny your claim because they believe an extreme windstorm caused the crash and not their insured driver’s negligence.

Reporting the Accident or Injuries Late

It is extremely important to file your claim immediately after the accident.  Any delay can lead to a denial.  If you failed to inform them of the car crash in a “timely” manner, insurance adjusters might use this as an excuse to deny your claim. Say you don’t report the accident to the police and your insurer or you did not immediately get medical attention. The insurance company will say you must not have been hurt if you didn’t report it or seek medical treatment right away.  And may even say they have suspicions of “insurance fraud.”  Again, don’t let the insurance companies push you around.  Hire a highly experienced personal injury legal emergency services lawyer to fight for your rights!

Your Claim Exceeds Policy Limits

If you try to file a claim that is worth more than the insurance coverage purchased, the amount that exceeds the limit will be denied. For example, if the at-fault driver has $30,000 of bodily injury liability coverage, which is the state minimum insurance coverage in Texas, and you submit a claim for $45,000 in medical bills, the additional $15,000 would be denied.  You may have to file an underinsured/uninsured motorist claim under your own policy to be properly compensated.  Or you may even need to proceed to trial to get a verdict against a solvent defendant.  Car wreck cases are more complicated than people think.  Again, hire a highly experienced personal injury legal emergency services lawyer to sort through the law and get you properly compensated.

You Were Driving Illegally When the Accident Occurred

Suppose you were violating the law at the time of the car crash (for example, driving under the influence of alcohol or on a suspended license). Your claim might be denied for your illegal activity even if the other party is at fault and your violation did not contribute to the accident.

What should I do when my car insurance denies a claim?

If your auto insurance claim was wrongfully denied, you’re not out of luck. You can take action to have the insurance company’s decision reconsidered and reversed.  You still have rights.

When the reason the insurance company says your claim was denied is factually inaccurate or contrary to the terms of your policy, you have a right to dispute the decision. If you believe your insurance claim was incorrectly rejected after reading the insurer’s explanation and reviewing the terms of your policy, your insurance policy and state law give you the right to appeal.

Here are a few steps you can take if your claim is wrongfully denied:

  • Ask the insurance company to provide a letter explaining the reasons for the denial.
  • Write a letter explaining to the insurance company why your claim was wrongly denied and provide documentation to support your arguments. 
  • Appeal the company’s decision by submitting a formal complaint to the Texas Department of Insurance.

You also have the option to go to court.  You can file a lawsuit against your own insurance company if you had to.  You can sue the insurance company directly if they violated their duty to settle your car accident insurance claim in “good faith.” Good faith means that insurance companies have a legal obligation to negotiate and promptly offer a fair settlement for your car crash claim.  

If your insurer does not act in good faith when denying your claim, you can sue for bad faith insurance practices, breach of contract, and any violations of the state insurance code. 

Do I need a car accident lawyer if my insurance claim is denied?

If your insurance claim is denied, you should consult with a car accident lawyer as soon as possible. An experienced personal injury legal emergency services lawyer at Attorney911 can review your case and determine the best way to dispute the denial of your claim. If a lawsuit is the best route, an attorney can take the insurance company to court to sue them for bad faith or pursue a personal injury suit.

While an attorney can help you after your claim is denied, the best time to talk to a lawyer is immediately after your accident. Even if you think your case will be entirely straightforward, claims adjusters are always looking for reasons to deny claims. A skilled lawyer can negotiate with the insurance company to secure a top settlement offer and prevent the adjuster from acting in bad faith. If you are represented by counsel, the insurance companies can only speak to you when your lawyer is present, and they will generally just communicate directly with your attorney.

Do I need a car accident attorney near me?

We always recommend finding a car accident attorney near you to take your case. Even though many of the laws are the same throughout the state of Texas, each county and city will have its own little quirks and customs. An attorney who regularly practices in your area will grasp the local legal culture and have connections to help them navigate the system. If you or a loved one has been injured in a car crash and your insurance claim has been denied, you should schedule a consultation with a personal injury legal emergency services attorney near you as soon as you can.

Have questions? We protect victims like you every day.

Call 888-ATTY-911

Email ralph@atty911.com

About Attorney911 
Legal Emergency Lawyers™ legal services

Attorney911 Legal Emergency Lawyers™ legal services is a Texas-based personal injury and criminal defense law firm with offices in Houston and Austin, though we are proud to serve Texans from all over the state and represent clients in federal court. We handle a wide variety of legal issues — from car accidents to worker’s compensation to DUI/DWI offenses. Our staff is bilingual, friendly, and genuinely passionate about helping our clients, whether it’s a million-dollar case or a thousand-dollar case. We also understand that cost can be a prohibitive factor in hiring a lawyer, and are willing to work with you on structuring payment in a way that is fair and feasible. We do accept credit cards for our hourly fees, and take some cases on contingency, which means you don’t pay us unless and until you get paid yourself. We know that you have a choice in your legal representation, and we believe that what makes us stand out from the competition is our real emotional investment in our clients. We see you as a person — not a paycheck. And we will fight hard for you, because we truly care.