Auto Insurance Claims: Handling Disputes And Getting Results

Disputing an auto insurance claim can be a stressful process, but there are steps you can take to resolve the issue. It's important to act promptly and gather as much evidence as possible to support your case. First, notify your insurance company that you are unhappy with the outcome of your claim and intend to take action. Then, review your policy and state insurance laws to understand your rights and identify any violations. You can also request an independent appraisal of the damage to strengthen your case. Keep a record of all communications and follow up with a written letter outlining your reasons for disputing the claim. If these steps don't lead to a resolution, you may need to contact your state insurance department or seek legal advice.

Understand your state law and your insurer's obligations to you

Understanding your state's laws and your insurer's obligations to you is crucial when handling a dispute with an auto insurance claim. Each state has different requirements for auto insurance, and it's important to know what your state mandates. For example, most states require liability coverage for both bodily injury and property damage. The minimum coverage limits vary, with common limits being $25,000 for injury to a single person, $50,000 total for multiple people, and $25,000 for property damage.

Some states also require uninsured motorist coverage and personal injury protection (PIP). Uninsured motorist coverage protects you if you are in an accident with a driver who doesn't have insurance. PIP provides coverage for your own medical expenses and lost income, regardless of who is at fault. While insurers in some states are required to offer these coverages, you may have the option to reject them in writing.

In addition to the state requirements, your insurance company may also have specific obligations outlined in your policy. Review your auto insurance policy carefully to understand what is covered and what steps you need to take in the event of a dispute. Your policy will also outline the options available to you for settling disputes, such as arbitration or appraisal services.

If you are unsure about your rights and obligations, you can contact your state insurance department or seek legal advice from an attorney specializing in auto insurance. They can help you understand your state's laws and your insurer's obligations and guide you through the process of disputing a claim.

Gather evidence and documentation

Gathering evidence and documentation is a crucial step in building a strong case to dispute an auto insurance claim. Here are some detailed instructions to help you through the process:

• Collect Evidence from the Accident Scene: If possible, start collecting information and evidence as soon as possible after the accident. Take photographs or videos of the accident scene, including damage to vehicles involved, vehicle license plates, traffic signs and signals, and the exact location of the accident from different angles. These visual records can be highly valuable in supporting your claim. Remember to include date stamps on the photos or videos if possible.
• Obtain Witness Information: Get the names and contact information of witnesses who saw any part of the accident. Witnesses who are uninvolved and have no personal connection to those involved in the accident are often seen as more credible. Their statements can provide valuable third-party confirmation of your version of events.
• Acquire a Police Report: Get a copy of the police report, also known as the "incident report" or "accident report," as it includes valuable information such as statements from drivers, passengers, and witnesses, as well as observations and opinions from the responding officer. This report may support your claim, especially if the officer concludes that the other party was at fault.
• Medical Records and Bills: Gather all medical records and bills related to any injuries you sustained in the accident. This includes hospital and doctor bills, radiology expenses, physical therapy records, and any other relevant documentation. These records are essential to demonstrate the extent of your injuries and the resulting financial impact.
• Vehicle Damage and Repair Estimates: Collect repair estimates or invoices for any damage to your vehicle. If your car is deemed a total loss, you will need to determine its actual cash value before the accident. Having photos, receipts, and other proof of the pre-accident condition of your vehicle can be helpful in disputing the insurance company's valuation.
• Keep a Journal: Consider maintaining a journal or diary to document everything you experience as a result of the accident. This can include physical injuries, emotional distress, missed workdays, lost income, and any other relevant details. These records can help you explain the impact of the accident on your life and support your claim for compensation.
• Lost Income Documentation: If you had to take time off work due to injuries or other consequences of the accident, gather documents such as pay stubs, direct deposit records, or tax returns to prove your lost income. If you are self-employed, keep track of any lost business opportunities or income due to your inability to work.
• Other Relevant Records: Depending on the specifics of your case, there may be other types of records or documentation that could support your claim. For example, if there is dash cam footage of the accident, obtain a copy as it could provide valuable evidence of how the accident occurred and who was at fault.
• Organize and Safely Store Your Documentation: Ensure that all the evidence and documentation you gather is safely stored and well-organized. Create digital backups of important documents and photos, and consider creating folders (either physical or digital) for different categories of evidence to make it easier to locate specific items when needed.

Remember, the key to a successful dispute is often the strength and amount of evidence you can provide. Take the time to thoroughly review the details of your case and identify any additional documentation that could support your position.

Contact your insurer

Contacting your insurer is the first step in handling a dispute with an auto insurance claim. Here are some detailed steps to guide you through the process:

Step 1: Notify Your Insurer of Your Disagreement

It is important to promptly notify your insurance company of your disagreement with their decision. You can do this by calling them and following up with a written notification, such as a letter or email. This step is crucial as it creates a record of your disagreement, which may be important for your case. Be sure to include your claim number and contact information in your written notification.

Step 2: Understand the Reason for Denial

Before taking further action, carefully review the denial letter sent by your insurer. This letter should outline the specific reasons for the denial and provide supporting evidence for their decision. Understanding the reason for the denial will help you plan your next steps and gather the necessary evidence to support your appeal.

Step 3: Gather Evidence and Documents

To strengthen your case, gather as much evidence as possible to support your appeal. This can include police reports, eyewitness statements, medical bills, photos from the accident scene, and any other relevant documentation. Your evidence should clearly demonstrate to the insurance company that you were not at fault or that their decision is incorrect.

Step 4: Follow the Appeals Process

Most insurance companies have a defined process for appealing a claim. Review your insurance policy to understand the specific procedures and requirements for filing an appeal. This may include providing additional documentation, explaining why you are appealing, and presenting your side of the story to an insurance adjuster. Be persistent and don't give up if your initial appeal is denied.

Step 5: Consult an Attorney

If you feel overwhelmed or unsure about handling the dispute on your own, consider consulting an attorney who specializes in auto insurance. They can provide valuable guidance, ensure your rights are protected, and help you build a strong case. Each state's bar association offers a free legal referral service to connect you with qualified candidates. Remember to discuss and understand the attorney's fee structure before engaging their services.

Complain to your insurer's internal dispute resolution team

If you believe your insurer has unfairly declined your claim, you should complain in writing to your insurer's internal dispute resolution (IDR) team. The IDR department undertakes a separate and independent review of customer complaints, including the outcome of claims. They should keep you updated on their process and notify you about their final decision.

Before contacting the IDR team, it is essential to understand your insurance provider's obligations to you. If your insurer has fully or partially declined your claim, they are required to inform you in writing of the aspects of your claim that they do not accept, the reasons for their decision, and your right to request information about the evidence used to assess your claim. You also have the right to ask for copies of any external expert reports they relied on and should receive them within 10 business days.

When writing to the IDR team, include as much evidence as possible to support your appeal. For example, you can provide copies of medical bills, photos from the accident scene, and other pieces of evidence that show the insurance company why you were not at fault. Your evidence should be compelling and make it clear that you are not responsible for the accident.

It is also important to document all communications with the insurance company. Keep written records of any letters, emails, and reports, and summarise any phone conversations, including the names of the employees you speak to and the dates and times of the conversations.

Contact your state insurance department

If you have tried to resolve your dispute with your insurance company and are still unsatisfied with the result, you can contact your state insurance department. This is the department that regulates private insurers. Explain the reasons for your disagreement to a consumer services representative. While they may not be able to resolve every complaint, they will collect the information and notify you if your case is chosen for an individual review.

The complaint process will differ depending on the state. In many states, you can submit a complaint online or by downloading a complaint form. You should always respond promptly to the department's requests for documentation or further information.

If you are based in Australia, you can contact the Australian Financial Complaints Authority (AFCA), a non-government ombudsman service that offers a free dispute resolution service for customers. All decisions made by the AFCA are binding, provided they are accepted by you. You must make a complaint within two years of receiving a written response from your insurer's internal dispute resolution team.

Frequently asked questions