If the insurance company denies your claim after a car accident, it can feel like you're facing an uphill battle as you deal with property damage, injuries, and lost income or wages
Here at DJC Law, we understand the complexities of car accident claims and the frustration of denied coverage. In this blog, we offer some steps you can take if your claim has been denied and how a Austin car accident attorney can help.
Reasons Why Insurers Deny Car Accident Claims
The first step is to understand why the insurance company denied your claim. There are many reasons why insurance providers may deny claims, often related to policy terms, the details of the accident, or the evidence provided.
Whatever the reason, the insurance company should provide you with a written explanation outlining the reason for denial. This will help you determine the best course of action moving forward. Here are some common reasons for denial:
Policy Exclusions
Insurance policies typically list specific scenarios that are not covered. If your accident falls into one of these excluded categories, the insurance company may deny your claim. Common exclusions include accidents involving illegal activities or driving under the influence.
Lapsed Insurance Policies
If the insurance policy was not active at the time of the accident due to non-payment of premiums or cancellation, the insurance company will deny the claim. Maintain continuous coverage.
Insufficient Coverage
The policy may not cover certain types of damage or may have limits that are exceeded by the cost of the accident. For instance, if you only have liability coverage and the crash damaged your vehicle, your policy may not cover the repairs.
Disputed Liability
Insurance companies might deny a claim if they believe their policyholder is not at fault for the accident. This can also happen if there is a dispute over the degree of fault. For example, Texas follows a modified comparative fault rule, meaning that the amount of compensation you're entitled to can be reduced by your percentage of fault in the accident. If you are more than 50% at fault, you cannot recover damages.
Failure to Report the Accident
Policyholders are typically required to report accidents within a certain timeframe. Failing to do so can result in a claim denial, as it could affect the insurer's ability to investigate.
Incomplete Documentation
Claims often require extensive documentation, including police reports, witness statements, and proof of damages. Inadequate or missing documentation can lead to denial.
Questionable or Fraudulent Claims
If an insurance company suspects a claim is fraudulent or exaggerated, it will investigate further and may deny the claim if evidence supports these suspicions.
Pre-existing Damage
Claims may be denied if the insurance company believes the damage was pre-existing and not a result of the reported accident.
Violation of Policy Terms
Engaging in activities that violate the terms of the insurance policy, such as unauthorized drivers using the vehicle or using the vehicle for commercial purposes without proper coverage, can lead to claim denial.
Steps to Take After a Claim Denial
Once you understand why the insurance company denied your claim, you can bolster your claim if you:
- Review the Denial Letter Carefully With a Lawyer: The first step is thoroughly reviewing the denial letter. Insurance companies are required to provide a reason for the denial. Understanding their justification is key to challenging their decision.
- Gather Additional Evidence: If your claim was denied due to insufficient evidence or a disputed fault, gather more evidence. This can include medical bills, photos of the scene, witness statements, police reports, or anything else that can support your claim.
- Appeal the Decision: Most insurance companies have an internal appeal process. You can submit the additional evidence you've gathered and argue why it should reconsider your claim.
- Consult an Attorney: Often, the best course of action is to consult a legal professional. An attorney who handles car accident claims can provide valuable advice on how to proceed. They can help you navigate the appeal process or represent you in legal actions if necessary.
- Consider Mediation or Arbitration: If the dispute cannot be resolved through the insurance company's appeal process, mediation or arbitration might be a viable next step. Both are alternative dispute resolution methods that can be less costly and time-consuming than going to court.
- File a Complaint: If you believe the insurance company has acted in bad faith, you can file a complaint with the Texas Department of Insurance. They can investigate the matter and may provide assistance in resolving the dispute.
- Legal Action: As a last resort, you may consider filing a lawsuit against the insurance company. Let your attorney do this. They can assess the strength of your case and advise on the likelihood of success.
What Damages Are Available to Car Accident Victims?
In Texas, after a car accident, you may recover damages, depending on your case. Damages in Texas are generally categorized into economic damages and non-economic damages. Here's a breakdown:
Economic Damages
These are tangible, out-of-pocket expenses that bills and receipts can document.
They include:
- Medical Expenses: Costs for medical treatment related to injuries from the accident, including hospital bills, medication, physical therapy, and any future medical care related to the accident injuries.
- Lost Wages or Income: Compensation for the income lost due to time off work because of injuries sustained in the accident. This also covers loss of earning capacity if the injuries impact your ability to earn money in the future.
- Property Damage: Costs to repair or replace your vehicle and any personal property damaged in the accident.
- Other Out-of-Pocket Expenses: Any other direct expenses incurred because of the accident, such as rental car fees and transportation costs to medical appointments.
Non-Economic Damages
These damages are intended to compensate for losses that aren't easily quantifiable with a receipt or invoice.
They include:
- Pain and Suffering: Compensation for the physical pain and emotional distress suffered as a result of the accident.
- Mental Anguish: Compensation for psychological impact, such as depression, anxiety, and trauma stemming from the accident.
- Disfigurement: Compensation for permanent changes to your appearance.
- Physical Impairment: Compensation for long-term or permanent loss of bodily functions or mobility.
- Loss of Consortium: Compensation for the impact of the injuries on the relationship between a victim and their spouse.
How Can a Lawyer Help Me if the Insurance Company Denied My Claim?
Dealing with insurance companies can be daunting. Legal representation from a firm like DJC Law in Austin can make a significant difference in the outcome of your case. An experienced attorney can:
Help You Understand the Denial
A lawyer can help you understand the specific reasons behind the denial of your claim. Insurance jargon can confuse you. A legal professional can interpret the language and implications for you. They can assess whether the denial is valid based on the insurance policy terms and applicable laws.
Gather and Analyze Evidence
Lawyers have experience in gathering the necessary evidence to support your claim. This includes obtaining accident reports, medical records, and witness statements. They can also arrange for testimonies from accident reconstruction experts or medical professionals to strengthen your case.
Navigate the Appeals Process
An attorney can guide you through the insurance company's internal appeals process, ensuring you meet all deadlines and requirements. They can represent you during the appeal, presenting evidence and arguments on your behalf.
Negotiate with Insurance Companies
Lawyers are skilled negotiators who can leverage their experience and knowledge to advocate for a fair settlement. They can ensure you're not pressured into accepting a settlement for less than what you deserve.
Pursue Legal Action
If the appeal is unsuccessful, a lawyer can help you file a lawsuit against the insurance company. They can develop a legal strategy tailored to the specifics of your case, potentially leading to a court-ordered compensation.
Advocate in Court
If your case goes to court, having a lawyer ensures you have an experienced advocate to present your case effectively. Lawyers are familiar with court procedures and can navigate the legal system on your behalf, making compelling arguments and objecting to improper evidence or procedures.
Advise on Alternative Resolutions
A lawyer can advise on alternative dispute resolution methods, such as mediation or arbitration, which can be quicker and less expensive than court proceedings.
Protect Your Rights
An attorney can explain your rights under the law and ensure that the insurance company respects those rights. They can prevent the insurance company from taking advantage of you, ensuring you are treated fairly throughout the process.
Is There a Deadline for Filing a Car Accident Lawsuit?
Yes, there is a deadline for filing a car accident lawsuit in Texas, known as the statute of limitations. For most car accident cases, including personal injury and property damage claims, Texas law sets this deadline at two years from the date of the accident. This means you have two years from the day the accident occurred to file a lawsuit against the parties you believe are at fault for your injuries or property damage.
You need a lawyer to monitor this deadline for several reasons:
- If you attempt to file a lawsuit after the two-year statute of limitations has expired, your case is very likely to be dismissed by the court, and you will lose the opportunity to seek compensation through the court system.
- The statute of limitations encourages prompt investigation and filing of claims, which helps ensure evidence is preserved and witness memories remain fresh.
- Knowing this deadline can help you better navigate your negotiations with insurance companies, as they are also aware of the time limit.
A few exceptions to the two-year statute of limitations might extend the deadline under certain circumstances, such as if the injured party is a minor or if the defendant leaves the state for a period. However, these exceptions are specific and limited, so you need a lawyer who can explain how they apply to your situation.
Given the complexity of legal claims and the importance of timely filing, it's advisable to consult with a personal injury attorney early on if you've been involved in a car accident in Texas. An attorney can provide guidance on the legal process, ensure you meet all critical deadlines, and secure the compensation you deserve.
Contact a Car Accident Lawyer in Austin You Can Trust
The denial of a car accident claim can feel like a significant setback, but with the help of a knowledgeable lawyer, you can navigate the appeals process, negotiate effectively, and even pursue legal action if necessary. Their knowledge not only increases your chances of a favorable outcome but also alleviates the stress and burden of dealing with complex legal and insurance issues on your own.
If the insurance company denied your car accident claim, you have options and rights you can exercise with the right approach and support.
The personal injury lawyers at DJC Law in Austin, we're committed to helping you through every step of the process, ensuring you're not alone in this challenging time. If you're facing a denied car accident claim, contact us today at (512) 888-9999 or through our online form for your free consultation and to see how we can help.