After a car accident, it is important to understand that the insurance company is not on your side. Whether it is your insurer or another driver’s insurer, these are businesses which will fight to pay you as little as possible. If they can get away with paying you nothing, they will. That’s why it’s important to understand the common reasons for car accident claim denials so you can prepare yourself ahead of time.
What Are the Most Common Reasons for a Denied Claim?
There are a few reasons the insurance company will likely point to in denying your claim. While fine print and slippery contract language may cause you trouble, the following are more likely to cause your claim to be denied.
1. The Accident Was Your Fault
Your claim may be denied based on a finding that you were primarily responsible for the injuries you suffered. Texas uses a Modified Comparative Fault Rule when deciding liability for an accident. If an injured party is more than 50 percent responsible for the accident, that party cannot recover compensation in court. So the insurance company can say that you were more at fault for the crash than other factors and deny your claim.
2. There Is No Valid Insurance Policy Covering the Accident
Another reason insurance might deny your claim is that there is no active policy covering the collision. If the at-fault driver allowed his or her insurance policy to lapse, the insurer will not pay. Unpaid premiums and uninsured drivers are a significant problem in Texas and many injured parties are left trying to collect from their own insurance companies, even though someone else caused the accident.
3. Pre-Existing Medical Issues
An insurance company may try to deny your claim based on medical problems you suffered before the accident. If you’ve been treated for things like back pain or arthritis, the insurance company might claim that your pain is based on these existing conditions, rather than on damage suffered in the accident.
That said, insurance should still cover any worsening of your condition based on the accident. A pre-existing condition doesn’t mean you can’t make a claim. It just means that you need to show that the accident was the cause of your suffering.
4. Insufficient Medical Documentation
Insurance companies will not take your word for it that you were hurt in an accident. You need to present proper evidence in the form of medical records, tests, reports and more. This is why you should always see a doctor after any car accident. If you wait to get medical help, the delay can be used by insurance companies to justify denying your injury claims.
What Is a Bad Faith Denial?
Insurance companies are required by law to act in good faith, dealing fairly with the people they insure. Insurance companies are not allowed to intentionally delay proceedings, needlessly confuse the process, or trick you out of the compensation you have coming. If the insurance company owes you money, and knows it, denying your claim can lead to an insurance bad faith claim against them.
Was Your Car Accident Claim Denied? Call Us for Help.
A Texas insurance claims attorney can help you deal with insurance adjusters and the red tape standing between you and the money you deserve. If your claim has been denied or you are having trouble navigating the insurance process, you should speak to a lawyer as soon as possible.
