Orlando Harmon
Dealing with insurance companies after a car accident can be a stressful experience. While insurance companies are supposed to help you obtain the money you need, especially if you were not at fault for the crash, they are also a business that wants to make a profit. This means that insurance adjusters will try to get you to admit fault so that they can justify paying you less than you deserve or deny your claim altogether. If your claim is denied, you can appeal the decision by gathering evidence, drafting an appeal letter, and, if necessary, hiring an attorney.
| Characteristics | Values |
|---|---|
| What to do if your claim is denied | Understand the reason for the rejection, gather evidence, draft an appeal letter, consider hiring an attorney |
| How to avoid claim denial | Pay insurance premiums on time, choose the right coverages, understand your policy, report the accident promptly, keep receipts for any roadside service expenses |
| What not to say to your insurance company | Don't admit fault, don't say you aren't injured, don't sign any releases, don't make an official or recorded statement |
| What to say to your insurance company | Where you are employed, where and when the accident occurred, the vehicles involved in the crash, the identity of any witnesses |
What You'll Learn
Submit additional evidence
If your auto insurance claim is denied, you will likely receive a denial letter from your insurance company. This letter should outline the reasons for the denial. If you feel that the insurance company has made an error, you can submit additional evidence to support your claim.
The type of evidence you can submit will depend on the specifics of your case, but here are some general examples:
- Police report: If a police report was filed after the accident, you can submit it as evidence. It will contain important details about the accident, such as the time, date, location, and any witnesses.
- Pictures of the accident: If you took photos of the accident scene, damage to the vehicles involved, and any relevant road conditions, submit them to support your claim.
- Repair estimates: Obtain repair estimates from a reputable auto repair shop and submit them to your insurance company.
- Medical records and bills: If you were injured in the accident, submit your medical records and bills as evidence. This is especially important if your claim involves personal injury protection or medical payments coverage.
- Witness statements: If there were any witnesses to the accident, their statements can be valuable evidence. Obtain their contact information and, if possible, written or recorded statements.
- Expert opinions: In some cases, you may need to hire an independent expert, such as an accident reconstruction expert or a medical professional, to provide an opinion that supports your claim.
When submitting additional evidence, it is important to be thorough and provide as much relevant information as possible. Make copies of all the evidence for your records and provide the originals to the insurance company. It is also a good idea to review your insurance policy to understand the specific requirements and time limits for submitting additional evidence.
If, after submitting additional evidence, your claim is still denied, you may need to consider other options, such as filing an appeal or seeking legal assistance. Remember to carefully review the reasons for the denial and consult with a trusted advisor or attorney if needed.
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File an appeal
If your auto insurance claim has been denied, you can file an appeal. Here are the steps you can take:
Gather Evidence
Collect all the relevant documents to support your appeal, such as police reports, eyewitness statements, photographs, medical records, and invoices from repair shops or medical providers. The more evidence you have, the stronger your case will be. Go through the documentation provided by the insurance company and gather any additional evidence you need to support your appeal.
Review Your Insurance Policy
Understand your coverage, policy limits, and exclusions. Knowing your policy details will help you determine if the denial was justified and will guide your next steps.
Draft an Appeal Letter
Write a letter to your insurance company explaining why you believe your claim should be accepted. Reference your policy information and the claims denial letter. Provide a detailed explanation for each piece of evidence you have gathered. Be sure to follow the instructions and deadlines outlined in your policy for filing an appeal.
Consult an Attorney
Consider hiring an attorney, especially if you feel uncomfortable handling the appeal on your own. An experienced car accident attorney can guide you through the process, review your case, and draft a compelling demand letter to the insurance company. While it may incur upfront costs, it could be worthwhile to have expert support in getting the claim denial overturned.
Understand the Denial Reasons
Before filing your appeal, make sure you understand the reasons for the claim denial. Review the denial letter from the insurance company carefully and identify the stated reasons for the rejection. This will help you address their specific concerns and provide relevant evidence to support your appeal.
Follow Up
Keep track of the progress of your appeal by maintaining regular communication with your insurance company. Document all correspondence and conversations for your records. If your appeal is denied, you can consider reaching out to your state's insurance commissioner or insurance department for further assistance.
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Hire an attorney
If your auto insurance claim has been denied, hiring an attorney can be a good option to help you navigate the complexities of the situation and protect your rights. Here are some important considerations and steps to take when hiring an attorney to force auto insurance companies to admit your claim:
Understanding Your Options
First, it's important to understand that hiring an attorney is not your only option. You have the right to appeal the insurance company's decision and submit additional evidence to support your claim. However, if you feel that you need more support or expertise, hiring an attorney can be a valuable investment.
Choosing the Right Attorney
When hiring an attorney, look for someone who specializes in car accident claims and has experience dealing with insurance companies. You can search for attorneys in your area who offer free consultations to get a sense of their expertise and how they can help you. It's important to feel comfortable with the attorney you choose and to make sure they have a clear understanding of your case.
Providing Necessary Information
Once you've chosen an attorney, they will need as much information as possible about your case. This includes any documentation provided by the insurance company, police reports, eyewitness information, photographs, medical records, and bills. The more information your attorney has, the better they can build your case and challenge the insurance company's denial.
Developing a Legal Strategy
Your attorney will review all the evidence and develop a legal strategy to force the insurance company to admit your claim. This may involve drafting a demand letter, negotiating with the insurance company, or filing a lawsuit if necessary. Your attorney will guide you through the legal process and ensure your rights are protected.
Understanding Costs and Fees
Hiring an attorney can be expensive, so it's important to discuss costs and fees upfront. Some attorneys work on a contingency fee basis, which means they only get paid if they successfully challenge the insurance company's denial. Others may charge by the hour, so be sure to clarify the payment structure before engaging their services.
Hiring an attorney to force auto insurance companies to admit your claim can be a complex and time-consuming process, but it may be necessary to ensure you receive the compensation you deserve. Attorneys have the legal expertise to navigate the claims process and improve your chances of a successful outcome.
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File a complaint with your state's insurance commissioner
If your auto insurance claim has been denied and you've exhausted all other options, you can file a complaint with your state's insurance commissioner. This is a viable option for both first-party and third-party claim denials.
Each state has a specific government agency that regulates insurance companies and accepts and investigates consumer complaints against them. These agencies can help you resolve your dispute with the insurance company and facilitate a settlement.
- Be prepared to fill out a form, either on paper or online, with information such as your name, address, type of insurance, and the reason for your complaint.
- Gather supporting documents and photographs. This includes email correspondence and a log of phone calls with your insurance agent or company.
- Write a detailed account of what happened and why you are filing a complaint.
- Visit the National Association of Insurance Commissioners (NAIC) website to select your state and navigate to its consumer complaint page.
- Submit your complaint. Your state's Department of Insurance (DOI) takes complaints seriously and is prepared to help you resolve the issue.
It is important to note that the process for filing a complaint may vary slightly depending on your state, so be sure to review the specific instructions for your state's insurance regulator.
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Don't admit fault
It's important to understand your coverage and follow the claims process outlined in your policy. Here are some key points to remember when dealing with auto insurance companies and claims:
- Avoid polite apologies: It's natural to want to apologise or admit fault after an accident, but this can compromise your case and reduce your chances of receiving fair compensation.
- Be truthful to the police: Provide only objective details of what happened. Don't lie, but keep your explanation concise and stick to the facts.
- Avoid talking to insurance adjustors without a lawyer present: Insurance companies will want to pay out as little as possible and may ask tricky questions. Having a lawyer present can help ensure your answers don't inadvertently compromise your case.
- Hire an experienced car accident attorney: They can review your case, create a defence, and navigate the insurance adjuster's questions.
- Understand the investigation process: Insurance adjusters will look into witness testimonies, statements made to the police, and statements made by the drivers to each other. They will also consider factors such as road conditions, mechanical issues, distracted driving, and failure to yield.
- Know your rights: You have the right to a timely and clear explanation of the insurance company's coverage decision, how they will pay your claim, and timely responses to your questions.
- Choose your auto repair shop: You typically have the right to choose the auto repair shop. Discuss with the insurance adjuster the type of parts they will use for repairs.
- Understand rental car coverage: If the other driver is at fault, their insurer may offer rental car coverage. If you are at fault, check your policy to see if you have rental car coverage.
- Keep records: Keep receipts for any roadside service expenses, such as towing, and protect your car from further damage.
- Understand subrogation: This is the right of an insurance company to pursue a third party that caused an insured loss, with the goal of recovering the amount paid for the loss.
- Be aware of state-specific laws: For example, in Indiana, if you are found 51% or more at fault, you cannot recover compensation.
- Follow up with a demand letter: If your claim is denied, you can send a demand letter to the insurance company, outlining your case and requesting a response.
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Frequently asked questions
First, make sure you get the reasons for the denial in writing. Then, gather evidence to support your claim, such as a police report, pictures of the accident, repair estimates, or medical records and bills. If you've submitted all the evidence you have, consider filing an appeal or asking for an appraisal from your insurance company. If you believe there's nothing else you can do, consider bringing in an outside party to help, such as filing a complaint with your state's insurance commissioner or hiring an independent claims adjuster or attorney.
Common reasons for claim denial include the person bringing the claim not being covered under the car insurance policy, the vehicle not being listed on the policy, there being no policy in effect at the time of the accident, the claim exceeding coverage limits, the insurance company's investigation concluding that the accident isn't covered, the claimant being unlicensed or intoxicated, the claimant's injuries being pre-existing, the insured failing to promptly report the accident, and the insured lying to the insurance company during the claim process.
If your third-party claim is denied, you can file an appeal, submit additional evidence to support your claim, or get help to fight the denial by hiring a lawyer and filing a lawsuit.
