​What Can I Do if an Insurance Company Denies My Car Accident Claim?

When you have suffered an injury in a car accident, you begin to incur costs practically immediately. Even if you have health insurance, your co-pays for your treatments mean you will get bills very shortly after the accident. In addition, your car accident may cause you to miss time from work, meaning that you have no money coming into your account. Immediately, you might begin looking into whether you can receive financial compensation for your injuries.

If you believe the other driver was at fault, you might file a third-party claim with their insurance company. You should have exchanged insurance information with the other driver at the scene of the accident. In the days following the accident, you might have gathered evidence regarding what happened and had an idea about the value of your damages.

Schedule A Free Consultation

Your First Decision Is How to Best Seek Financial Compensation

You will then face a decision about the best way to seek financial compensation. If the other driver was at fault for the accident, they have a legal obligation to pay for your injuries. Either their insurance company should cover the damages up to the policy limit, or a jury should order them to pay. In both cases, you will need to prove that the other driver was at fault.

Most people choose to deal with the insurance company or at least try to first before going to court. Even though the insurance company claims process is by no means quick, it will usually give you compensation before a jury will. Court cases can take years from start to finish.

Like a jury, the insurance company will require some level of proof that you should include with your claim. You will need objective evidence showing that the other driver was responsible for the accident.

Why Insurance Companies Deny Your Claim

The insurance company can deny your claim for several reasons, including:

• They believe that what happened was not covered under their driver’s insurance policy
• They do not think that you showed that their driver was to blame
• They may think that the accident was your fault
• Your claim may not be persuasive enough to show that you suffered any damages

The insurance company may not even be taking a position on whether its driver was negligent. They are looking at and weighing the evidence you have included in your claim. As the claimant, the burden of proof is on you to show that the other driver was negligent. The other driver may have given a statement at odds with yours, making your case a “truth contest.”

You Must Come up With Proof That Shows That You Deserve Financial Compensation

If the other driver’s liability is not entirely clear, it will be up to you to come up with the proof that backs up your side of the story. You need more than your word to be in a position for financial compensation. The insurance company has the luxury of sitting back and waiting for you to prove your claim. The insurance company should open settlement negotiations if they see enough evidence to persuade them of their policyholder’s liability.

However, the insurance company does not always do the right (or even smart) thing. As rational as these businesses are, the adjuster may be under their own pressure to deny as many claims as possible, even though that conduct can be illegal. You may need to take additional action to secure financial compensation for your car accident.

The Insurance Company Is an Intermediary Defending Their Policyholder

To fully understand this situation and your legal rights, you must understand the role of an insurance company in your car accident claim. The driver who was negligent in the accident is the one who has the legal obligation to pay you. The driver has paid the insurance company premiums to cover damages they cause up to the policy limit.

The insurance company also promises to defend the driver from a lawsuit. These companies often put their own financial interests above their duty to defend the client, potentially opening themselves up to a bad-faith claim.

The Insurance Company Has Their Own Motivation With Your Claim

The insurance company is doing everything possible to make the claim go away for as little money as possible. In some cases, it means that they try not to pay it at all. At the same time that the insurance company defends its policyholder, it also tries to pad its own profits along the way. The insurance company saves money if it can deny a claim or pay less than a claimant deserves.

These business practices are how all insurance companies operate. As much as it seems that personal injury lawyers demonize insurance companies, they are merely telling you how insurance companies handle claims and how they try to make money at your expense. Personal injury lawyers have seen this conduct repeatedly over the course of their careers.

The insurance company is a self-interested entity. You should never take its word as final if and when it denies your claim. The insurance company knows that you have the burden of proof and will not hesitate to deny a claim if it is a close call to force you to fight further.

The insurance company is making a calculation that you may go away without doing anything further. If you do take legal steps in court, the insurance company will need to pay its own legal defense counsel. You will not need to pay an attorney unless you successfully get a settlement or win your lawsuit.

The Insurance Company Usually Does Not Want to Go to Court

Most car accident cases avoid court because the insurance company realizes that the most sensible thing to do is settle your case. They know they might have to pay more by a jury. They also know they will incur additional expenses to hire an attorney to defend their driver in court. Finally, they know they can be in trouble if their decision to deny your claim was unreasonable in the face of compelling evidence.

However, you may not be one of the many people who can reach a settlement with the insurance company. In most cases, the insurance company is a rational business. While their business tactics can be underhanded, insurance companies are rational businesses at their core. They are always weighing their costs and risks with every decision they make.

If You Do Not Have a Lawyer, Hire One if You Receive a Claim Denial

Ideally, you should have hired an attorney at the outset of your legal process. A car accident lawyer will help you assemble the most persuasive claim possible, taking the time to assemble the necessary evidence and explain the basis of your claim. Many people make the mistake of trying to file the claim on their own to try to save money, and they only realize the depth of their mistake when the insurance company denies a claim that they believed was rock solid.

Regardless, you should definitely get a lawyer when the insurance company denies your claim if you do not have one already. Although you can always try to represent yourself in court, this is never wise or practical. You will not get far in front of a jury when you need to compile evidence and question witnesses in line with civil procedure rules.

Your lawyer will work on the legal strategy for your case. They will begin the legal process by drafting a complaint that describes what happened and explains why you deserve financial compensation for your injuries. They can then obtain more evidence than you previously had through discovery.

The insurance company’s denial can be a helpful roadmap for how you might improve your case in court. You may be missing key pieces of evidence that your lawyer can obtain and highlight in court. If the insurance company denies your claim because they believe you were the negligent one, your lawyer will prepare to address those arguments if the case goes to trial.

You Need to Prove Your Case, But Not By the Same Standard in a Criminal Case

If the insurance company denies your claim, you can file a lawsuit against the responsible driver in court. You can win your case in court if you can prove your case to a jury by a preponderance of the evidence. This legal term means that you have shown that your version of the facts is more likely than not to have happened. This legal standard is akin to showing that your facts are 51 percent likely to be true. You do not need to prove your civil case beyond a reasonable doubt as a prosecutor must in a criminal case.

You might wonder how you can prove your case to a jury if the insurance company did not think that your claim had enough merit to offer you a settlement. Again, the insurance company has different motivations than a jury. When you take a case to court, the jury’s only job is to weigh the facts and evidence to determine whether someone is liable. The jury does not have a profit motive or balance sheet. They do not answer to shareholders that may dump shares of stock if an earnings target is missed. An objective jury might be more likely to find merit to your claim.

In most cases, the insurance company will try to settle your case if they realize it has some merit. They do not want to incur legal costs in court, and they know that a jury will probably give you more money than they might pay in a settlement if you win the case. However, insurance companies do not always do what is expected of them, especially considering their corporate financial situations.

You May Have No Choice but to File a Lawsuit

Having your claim denied is not the only reason why you may file a lawsuit in court. The insurance company may simply refuse to offer you enough money in a settlement negotiation. There are many times when plaintiffs get far more money in a lawsuit than the insurance company offers them.

Of course, you also take a risk when you file a lawsuit. If you lose your case in front of the jury, you may end up with nothing. However, you do not have a choice if the insurance company denies your claim. If you do not file a lawsuit, you will have no other options for compensation. Filing a lawsuit is your way of getting an objective jury to decide your case when the conflicted insurance company has reached a wrong conclusion and works against you.

The Right Car Accident Lawyer Can Help You

If you suffered injuries in a car accident, you face many difficult decisions and concerns. Rest assured that you do not have to make important legal decisions on your own.

You can hire a car accident attorney at no upfront cost, and they will advise you on every step of your claim. Never wait to seek a free case evaluation with a trusted lawyer today.

Schedule A Free Consultation