5 Common Reasons Insurance Companies Deny Auto Related Injury Claims

Jun 28, 2023 | Personal Injury

If you are injured in an auto accident, you may have expected that your insurance company will pay your medical bills and other expenses right away. There are times, however, when immediate compensation does not materialize, despite the fact that you have the right to expect it.

Unfortunately, auto insurance companies deny injury claims every day. They do so for various reasons. While some are legitimate, others are not. The best way to find out if you have a valid injury claim is to discuss your accident and injuries with an experienced auto accident attorney. A lawyer can help you pursue a valid claim and will know what to do if it is wrongfully denied. If your claim has already been denied and you don’t have legal representation, now is the time to consult with a Texas attorney to find out about your rights and options!

Understanding some of the common reasons for auto insurance claim denials can help you avoid having yours denied. 

Disputed Liability

If the insurance company doesn’t believe their insured is at fault for the accident, they will often deny the claim outright. If they determine that there is joint responsibility for the accident, you might receive partial compensation depending on the amount of responsibility they are willing to accept on behalf of their insured. If they determine they have 50% or less responsibility, they will refuse payment, and may even request payment from your insurance company.  

Proving the other driver’s liability is extremely important in these claims. There must be evidence to support that they were the ones that caused the accident. An  auto accident attorney would prove invaluable at providing evidence to support these claims.

You Weren’t Medically Evaluated

After being involved in a motor vehicle accident, one of the first steps you should take is to seek medical evaluation by a licensed medical doctor. If your injuries are severe, you will likely go to the emergency room via ambulance. However, if you suffered minor injuries or didn’t really feel injured at all after your accident, you might be inclined not to get medical care. This is a mistake!

It is still important that you have medical documentation that you were in an accident, even if you don’t feel injured or only suffered mild injuries that can be treated at home. In some cases, injuries don’t present themselves for weeks or even months after an accident. The insurance company will likely argue that your injuries were caused by something other than the car accident if you wait to see a doctor. You can protect yourself and your claim by seeking a medical evaluation right away. 

Expired Statute of Limitations

An insurance claim must be reported within a specified period of time so that the insurance company can evaluate the evidence while it is still fresh. The insurance carrier can deny coverage if the claim isn’t reported within the allotted period of time. In addition, if you need to file a lawsuit for your personal injury claim, Texas law sets the personal injury statute of limitations for injuries arising from auto accidents at two years from the date of the injury. If you need to file a lawsuit but fail to do so on time, you won’t qualify for compensation.

The Claim Exceeds the Policy Limits

Suppose the amount you are requesting in compensation for your injury claim exceeds the amount of your insurance policy’s limits. In such cases, the insurance company might deny your claim. For example, if your claim is for $100,000 and your insurance policy covers up to $75,000, they may deny the whole claim or pay only up to $75,000. 

In these cases, it’s essential to have the representation of a skilled auto accident attorney in order to pursue all available and applicable insurance policies. For instance, if multiple drivers were responsible for your accident, you can seek compensation from their drivers’ insurance policies and receive full compensation for your damages. Or, a single driver might have multiple insurance policies to collect compensation from, such as their personal policy and an employer’s policy if they were working at the time of the accident.

Bad Faith

There are times when insurance companies deny injury claims despite having no justifiable reason to do so. Such an act is known as bad faith, which generally means that an insurer is using unethical reasons to deny, undervalue, or delay a claim. Insurance carriers who act in bad faith breach their contract with their insured and might face legal consequences.

In addition to denying a claim for no valid reason, insurance companies that intentionally slow the claims process or significantly undervalue a claim without a valid reason also act in bad faith. Other examples of bad faith include:

  • Misrepresenting relevant facts or insurance policy provisions
  • Requiring unnecessary documents
  • Repetitively asking for the same documents
  • Failing to acknowledge or act promptly upon communications

If the insurance company acts in bad faith regarding your claim, you deserve not only compensation for your injuries, but also compensation for bad faith damages. A Texas car accident lawyer can help you pursue not only your auto accident claim but also a bad faith insurance claim against the insurance company.

Do You Need Help With Your Injury Claim? Contact Us Today! 

The injury attorneys at Ted Machi And Associates, PC know how frustrating it can be to receive a denial for your claim. You might be worrying about how to pay your medical bills or compensate for your lost wages. How is it possible for the insurance company to do this to you? We are here to support you, so don’t give up yet! 

In fact, our lead attorney, Ted Machi, has vast litigation experience and extensive insurance law knowledge and uses it to leverage claims to his clients’ advantage. You can count on him to work tirelessly for the compensation you deserve. Contact Ted Machi to schedule your free consultation.

Ted Machi & Associates, P.C.

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