After the trauma and inconvenience of a car accident, it’s only natural to expect the insurance side of a car accident injury claim to run smoothly and compensate you for your losses. Sadly, insurance companies don’t always work as quickly as you would like in resolving these and many other injury claims. The reality is that insurance companies are businesses. Therefore, protecting their clients and maintaining overall cost control will always be top of mind.
Having an understanding of why some claims are denied can give you a better chance of having your claim approved. Here are 8 of the most common reasons that insurance companies deny car accident injury claims.
1. They believe you are at fault.
Before an insurance company pays any car accident injury claim, they will do their own investigations. For instance, they will look at how and where it happened, as well as secure statements from all parties. If the insurance company believes you are 100% at fault or at least share fault in the collision, they could deny the car accident injury claim or significantly reduce what they are willing to pay out for your damages.
Liability of the accident can be disputed when:
- Statements from involved parties conflict.
- There aren’t any witnesses.
- The police reports are inconclusive.
- There is no video evidence available.
- Weather or road conditions, such as signage or construction, inhibit and complicate the accident.
Accident fault is very subjective for those involved. You cannot assume the insurance company will choose your side. Compiling your own evidence can help your cause. Useful evidence might include personal photos and video from the scene, witness statements on exactly what happened, video footage from road cameras, evidence of vehicle damage and injuries, police reports, etc.
2. You took too long reporting the accident and filing the claim.
Most insurance companies require prompt reporting of accidents. People involved in accidents often delay reporting because they are not seriously injured or want to work it out themselves. While not the case 100% of the time, this often precludes good people such as yourself from being able to file car accident injury claims.
Delayed reporting can be a major problem in the long run. Therefore, it is imperative that after the initial exchange of information, any medical care, and taking pictures and notes on witnesses, you should promptly report the accident to the appropriate insurance companies, including your own insurer if your policy requires it, and notify the at-fault driver’s insurer if you intend to pursue a claim. You will also want to contact a personal injury attorney, as they, too, can work with the insurance company directly and on your behalf. Evidence such as skid marks, as well as memory and recall of witnesses, can fade as time passes, and it is important to start the process as soon as possible after the accident.
3. You don’t have enough evidence.
Insurance companies love documentation. After all, that documentation will be the basis of the claim and maybe a future lawsuit. Therefore, you need to be able to demonstrate with documentation about what happened, how you were affected, and any ongoing issues resulting from the accident.
As previously mentioned, strong evidence documentation can also include:
- Medical records
- Diagnostic imaging
- Doctor’s recommendations for treatment
- Physical therapy records
- Photographs of injuries
- Photographs of the cars immediately after the accident
- Repair estimates for the vehicle
- Lost wage documentation if the accident kept you out of work
- Any other receipts for accident-related expenses such as rental cars or anything else you may have needed to live that you didn’t use before the accident and had to purchase
Complete, organized documentation following a car accident injury will improve your case and assist the insurance company’s investigation. This makes it harder for them to challenge that claim.
4. They can’t substantiate your injury claims
Two of the most common challenges insurance companies pose after you file your car accident insurance claim are either that your injuries weren’t caused by the accident or that they aren’t as serious as you are claiming.
In denying a claim, insurance adjusters may cite:
- A delay in seeking medical treatment
- Gaps in when you were treated
- Any pre-existing medical conditions that may relate to the injury
- Inconsistent medical records
- Social media activity that may dispute your reported injuries
All of these factors can help the insurance company create doubt or “poke holes” in your case. Therefore, it is important that your activities follow your doctor’s treatment plans and that your online presence doesn’t dispute those claimed injuries. Attending all doctor’s appointments and therapy sessions will demonstrate the seriousness of your injuries and your commitment to resolving them.
5. You have a pre-existing condition
Even though you have been involved in a car accident and have filed an injury claim, that doesn’t preclude any ongoing or chronic conditions that existed before the accident. If they can find proof, insurance companies may argue that a pre-existing condition existed and was not caused by the accident.
However, that doesn’t mean that the accident didn’t worsen symptoms. This is why documentation from medical professionals before and after the accident will be important when pre-existing conditions exist. Also, any notes you can keep about changes or worsening of the condition, such as a pain journal, will be a good tool to present a stronger case.
6. Medical treatment doesn’t match the claim
Insurance companies will often compare the injuries you’ve claimed with the treatment you received. For instance, if there was a car accident injury claim that includes severe back and neck injuries, and you only attend one appointment and don’t follow up, the insurer could dispute the seriousness of the claim. By the same token, if you miss appointments or treatments, this may cause them to question your claim.
Documentation will accompany regular medical treatment and provides the insurer with a progression of your injuries and that medical treatment.
7. You missed important deadlines
To piggyback on a previous tip, there are important deadlines that can affect your claim, including reporting requirements under your own insurance policy and the statute of limitations for filing a lawsuit if a settlement cannot be reached. It is important to be familiar with those requirements. Missing a required deadline for a claim may jeopardize your ability to claim an injury. In addition to policy requirements, each state has limits on how long an accident victim must file a lawsuit if the insurance negotiations fail to provide a fair settlement.
Important deadlines can include:
- Reporting the accident to your insurance company
- Providing documentation as requested
- Responding to any inquiries by the insurance company
- Filing a legal claim before the statute of limitations expires in the state the accident occurred in.
Make sure you are familiar with your policy’s requirements and the state deadlines to avoid losing valuable and needed legal rights.
8. The insurance company simply disputes the value of your claim
Even if an insurance company acknowledges that you were in a car accident and that you were injured, it may not want to compensate you for what you are requesting. Common disputes may involve:
- Future medical expenses or ongoing treatment
- Lost wages or earning capacity
- Pain and suffering
- Permanent impairment
- The necessity of certain medical treatments
The disparity between what you need and what the insurance company thinks you need may not result in just a denial but a negotiation for your car accident injury claim. But this delay caused by ongoing negotiation can result in not receiving needed compensation and care.
What Should You Do If Your Car Accident Injury Claim Is Denied?
A denial is frustrating but doesn’t have to be final. There are alternative steps that can be taken when your car accident injury claim is denied. If you are denied compensation, try these steps to continue the claim:
- Make sure you carefully read the denial letter and its reasoning.
- Gather any additional, helpful documentation that can address any issues that were cited in the letter.
- Continue to follow your treatment plan and doctor’s recommendations.
- Don’t discuss your case on social media.
- Keep all copies of communication with the insurance company and medical professionals.
- Consult with an experienced personal injury attorney about your legal options.
A denied claim is not necessarily the end of compensation for a car accident injury claim. Further negotiation is possible to dispute it with additional evidence and documentation, and if necessary, legal advocacy.
Call Keys Law Offices Today!
A car accident injury claim that is not handled correctly can disrupt your life in an instant, leaving you with stress, injuries, and unanswered questions about what comes next. At Keys Law Offices, we are determined to support individuals and families struggling with such issues and offer them advice and representation in personal injury accident cases and other personal injury claims. With deep knowledge of how these cases are handled, our firm will strive to get to the bottom of the case, develop a strong claim, and seek the financial compensation you deserve.
Assistance is available, and help is only a phone call away.