Michael Damaso / 10-23-2020 / Insurance Claim Disputes

Reasons Why Your Car Insurance Claim Might Be Denied

Claim

After being involved in a car crash in Florida, the last thing you want is for any claim you make to your insurance company for injuries or property damages to be denied. There are some instances, however, when an insurance company may deny your claim leaving you financially responsible for the accident. It helps to understand why insurance companies deny certain claims.

The insurance company reviews several different factors when making determinations on a claim. They use a set of databases and tables to calculate the costs of injuries and damages, and while there may be a valid reason for the denial, many times, the denial can be completely arbitrary.

Florida is one of a dozen states that operates under no-fault insurance laws, which means that accident victims, first, must file a claim with their own personal injury protection (PIP) insurance policy for injuries and damages.

The insurance company may deny your claim in the event you drove under the influence at the time of the crash, or intentionally caused the accident. Florida is a pure comparative fault state, which means that an individual’s injury claim can be reduced based on the percentage of fault he or she played in the accident. If your own negligence caused the accident, the insurance company may argue that they are not required to pay your claim due to your negligent actions. One common reason is if the driver who caused an accident was breaking a law when the crash occurred. If the insured was driving drunk and caused a car accident, his or her insurance company may deny the claim.

Insurance companies may also deny a claim if the injured party did not immediately seek medical attention after the car crash. In Florida, car accident victims have 14 days to seek medical attention to receive compensation under their Personal Injury Protection (PIP) plan. That is 14 days from when the accident occurred. Many times, injuries do not manifest for days or even weeks after the crash occurs, but the longer you wait to be seen, the more the insurance company may argue that your “injuries” are related to something that happened after the accident itself, or was a pre-existing condition. To avoid this possibility, it is always best to be seen by a medical professional as soon as possible after the accident.  By doing this, you are making the case even stronger that your injuries are a direct result of the car accident and not something that occurred after the accident.

If the claim filed exceeds the insured’s maximum coverage, the insurance company may seek to deny the claim, as well. If you have uninsured motorist coverage, this can fill in the gaps between your costs and the other driver’s ability to pay. For example, if you are injured in an accident caused by an uninsured or underinsured driver.  Uninsured motorist coverage also reimburses you for pain and suffering, and economic damages.  It is for this reason that the insured person should always be aware of what his or her policy limits are, and the benefits covered under the policy.

Insurance companies often deny claims, as well, when the insured did not notify their insurance company quickly enough after the accident.

Occasionally, insurance companies deny claims out of bad faith, which means the reason for the denial is not ethical or even valid.  As the insured, you have a contract between you and the insurance company for coverage. Therefore, they are bound by the terms of that contract, and if they fail to meet these terms, that can mean they are acting in bad faith. Many times, the insurance company will take their time deciding on the claim, another sign they may be acting in bad faith. If you believe this is occurring, consult an attorney immediately to discuss what rights you may have to fight back against the insurance company.

Many people believe you should call the insurance company first before speaking with an attorney, and while it is important to report the accident to your insurance company- insurance companies do not have a duty to act in your best interest (even your own insurance company). Only an attorney must act in your best interest. By contacting an attorney, you can make sure you get compensated fairly for your injuries and damage sustained to your vehicle.

Wooten, Kimbrough, Damaso & Dennis, P.A. is based in Orlando, FL and was founded in 1966. The firm is comprised of award-winning trial lawyers who have obtained significant verdicts and settlements for the injured and their families throughout the State of Florida. We provide free consultations to all families suffering from wrongful deaths or injuries caused by car accidents or catastrophic injuries. If you are not sure where to turn following a serious car accident, call us today at (407) 843-7060.

Virtual sign-ups available. To learn more, visit https://www.whkpa.com/.

Disclaimer: All verdicts and settlements listed here are gross amounts before deductions for attorney fees and costs. Past results do not guarantee similar results in the future. Most cases result in a lower recovery. It should not be assumed that your case will have as beneficial a result. Before choosing a lawyer, ask for written information about the lawyer's legal qualifications and experience.