Like all businesses, insurance companies profit by taking in more money than they pay out – which is why you’ll generally find it easier to purchase a policy than to successfully claim against it. Nevertheless, you are not necessarily helpless when an insurance company denies your claim. You will need to understand the stated basis for denial, determine whether the denial of your claim was reasonable or not and, if necessary, contact a lawyer to help you press your claim. Above all, don’t sign anything without seeking legal advice first.
Most Common Reasons for Denial
- The insurance company alleges that the accident was partially or fully your fault. Even if the accident was partly your fault, however, most states will allow you to recover at least some of your damages, as long as you were less than 50 percent at fault. Some states will let you recover partial damages even if you were mostly at fault. Don’t let the insurance company trick you into believing that a slight degree of fault will bar you from recovery, because in most states this isn’t true.
- You were not treated right away. Failing to seek immediate treatment will allow an insurance company to claim that your injuries were not really caused by the accident – maybe you fell down the stairs and got hurt two days after the accident, for example.
- You had a pre-existing condition. Perhaps you’ve had back problems for years, and the accident made them worse. This will make it difficult to determine exactly how much of your disability was actually caused by the accident itself.
- You missed the statute of limitations deadline to file a lawsuit. Different states apply different deadlines. In some states, such as Kentucky, you have only one year from the date of the accident to file a personal injury lawsuit against the insurance company. If you can’t file a lawsuit because you missed the deadline, the insurance company will have no incentive to negotiate with you. Don’t let the insurance company lull you into missing the deadline through constant delays.
Insurance Company “Bad Faith”
Your insurance may be dealing with you in “bad faith” by making misrepresentations, trying to intimidate you or simply stonewalling you. If insurance company misconduct reaches a certain level, you may be able to win a “bad faith” lawsuit against the insurance company. Under certain circumstance you may even be eligible for punitive damages in addition to the normal compensatory damages.
Insurance company lawyers and claims adjustors tend to be savvy negotiators with years of experience dealing with claimants just like you. If you are anything like the average claimant, this will put you at a huge disadvantage – unless you have retained a car accident lawyer who is just as savvy and experienced as they are. If your claim is of significant value, it is wise to seek the services of a local personal injury lawyer before you even begin seriously negotiating with a stubborn insurance company.