After being involved in a car accident, your main concern after making sure there are no medical emergencies is how the insurance company is going to handle the claim.
A lot of people think that just by submitting an insurance claim, they would be compensated for their damages to pay for medical bills and additional costs. However, things don’t always work that way unfortunately. In many cases, you may face challenges in obtaining a fair insurance coverage including the denial of your claim.
If you’ve submitted an insurance claim and got denied, it’s important to dive deep into the reasons behind the denial. Of course, every situation is different and needs to be carefully examined to determine the reason. For the best results, be sure to consult an experienced car accident lawyer. Nonetheless, here are the most common reasons insurance companies give for denying customer claims:
Partial Fault for The Accident
In states where a comparative fault rule is followed like Nevada, insurance companies may deny a claim due to alleged comparative fault. Comparative fault basically means the injured party’s percentage of fault in the incident. If the insurance company believes or has proof that you have contributed to the injuries you received, they will most likely deny full coverage. However, they would still be liable to pay your percentage of the award.
Additionally, if you were engaged in an illegal behavior when you got into an accident, the insurance company has the right to deny you coverage. The easiest example would be drunk driving. Since driving under the influence is illegal in all states, your insurance company will most likely refuse to pay your damages. This also applies if someone unlicensed was driving your vehicle at the time.
Insurance companies are for-profit companies and will surely deny your claim if the company believes it isn’t financially responsible for your damages.
A Lack of Medical Evidence
After being involved in an accident, it’s pivotal to seek help from a medical professional. In many cases, injuries sustained from the accident could take days or even weeks to emerge. Without the proper proof including a full medical evaluation, the insurer’s attorneys could dispute your claim on the basis that it is hard to prove that your injuries were a result of the accident.
One thing to keep in mind is to ask the medical team to clearly indicate the reason for your injuries in your medical records. This will be extremely helpful to your case. Additionally, make sure you keep copies of all of the relevant medical documents related to your accident and treatment to submit along with your insurance claim.
Having a Pre-Existing Condition
In some cases, if the insurance company believes the injury you have sustained is pre-existing and not from the accident, they will try to deny your claim. This is why it’s very important to document your medical treatment very well and to never sign a medical authorization form sent to you by the insurance company. What they try to do is access your entire medical history to see if there’s any way they could use to deny your claim.
Maximum Insurance Coverage Exceeded
Since the amount of insurance coverage available on your insurance claim is limited, you might be denied benefits. There is a maximum coverage amount listed on the policy that you should keep close attention to. For example, you’re involved in an accident and the total damages exceed $75,000, your maximum coverage is $50,000. In this case, you can only recover full damages if there are other defendants who share the fault for the accident. If there’s more than one insurance company involved in your claim you’ll have a higher chance of recovering full compensation.
