When an insurance company denies your car accident claim, it can be frustrating and overwhelming, especially if you face medical bills, lost earnings, and vehicle repair costs. However, a denial does not always mean the end of your case. Insurance companies deny claims for many reasons—due to lack of documentation, disputed liability, or policy coverage issues, for example. Sometimes, denials come from unfair or incorrect interpretations of the facts.
The good news is that you still have options. Options include but are not limited to submitting additional evidence to the insurance company, negotiating, mediating, or filing a lawsuit; you can challenge the insurer’s decision and fight for the compensation you deserve. Having a knowledgeable attorney by your side can increase your chances of securing a favorable outcome and obtaining the money you need to cover medical expenses, lost earnings, and other damages. Contacting a Coral Springs car accident attorney at Cindy Goldstein Law is the first step. Call us at (954)346-5420 to speak to a car accident attorney.
Insurance Claim Denials - Key Takeaways
- When you file an insurance claim, the insurance company decides whether to accept liability and whether to offer you a monetary settlement.
- The insurance company may deny your claim for various reasons, making you think you have reached a dead end.
- The insurance company does not get the last word. You have legal rights after a car accident, and may be entitled to reasonable compensation.
- You can file a car accident lawsuit against all appropriate parties to seek the compensation you deserve.
- You should contact an experienced car accident attorney immediately following the crash, before you file a claim or speak to an insurance company, to have the best possible chance of success.
Why Does an Insurance Company Deny Your Car Accident Claim?
Insurance companies deny claims for several reasons. Insurance companies are big businesses so their job is to take your insurance premium money and pay out as little as they can on claims, so they maximize their profit. Hence, insurance companies seek to deny or mitigate any monetary claim possible. Insurance companies must operate in good faith and must comply with Florida Law. As such, insurance companies must provide a legal and factual explanation if they deny your claim.
One of the most frequent reasons for a car accident claim denial is based on liability. You must prove that the other driver was negligent in order to receive financial compensation for your injuries. Negligence means that the driver did something unreasonable, or fell below the standard of care, under the circumstances. You must meet your burden of proof by a preponderance of the evidence, meaning it is more likely than not that the adverse driver was negligent, and if the insurance company does not evaluate liability as such, it will deny your claim.
Common Reasons For Claims Denial
Here are some of the most common reasons why insurance companies deny car accident claims:
- Disputed Liability – The insurer argues their policyholder was not at fault or that you were partially or fully responsible.
- Lack of Evidence – There is insufficient documentation of liability, such as missing police reports or witness statements.
- Policy Exclusions -The accident falls under policy exceptions for their insured, such as using a vehicle for commercial purposes without disclosing to the insurance company at policy inception.
- Lapsed or Inactive Policy – The at-fault driver’s insurance policy expired or the insurance company canceled it prior to the accident.
- Delayed Reporting – You did not report the accident to the insurer within a reasonable period of time, prejudicing their investigation.
- Failure to Seek Prompt Medical Treatment – If you waited too long to see a doctor, insurers may claim your injuries were unrelated to the accident. Moreover, in a car crash in Florida, you must seek medical treatment within 14 days of the crash, otherwise you forfeit your PIP benefits under your automobile policy.
- Pre-Existing Conditions—The insurer argues that your injuries existed before the crash and that the accident did not cause or aggravate them.
- Your Own Statement - The adjuster claims that you made a statement admitting fault for the accident or denying you were injured when they spoke to you.
- Fraud or Misrepresentation – There are suspicions of exaggerating injuries, falsifying details, or providing inconsistent statements.
You Can Fight Back When the Insurance Company Denies Your Claim
You do not have to take the insurance company’s word as final when it denies your car accident claim. You can and should fight back with the help of an experienced car accident attorney. A consultation with Cindy Goldstein Law is always free, and an experienced personal injury attorney understands the details of the legal process and can counsel you on your legal options. Often once a personal injury attorney is retained, the attorney may be successful in challenging the insurance company on their evaluation or denial and may potentially file a lawsuit. Insurance companies know they will incur significant costs to defend against your lawsuit including attorneys fees, time, and costs, which they want to avoid. Insurance companies typically do not fear an unrepresented claimant, because they assume the claimant lacks the requisite knowledge of the claims process and legal options.
What Can a Car Accident Lawyer Do When the Insurance Company Denies Your Claim?
Having the insurance company deny your car accident claim can feel overwhelming, but it does not mean your case is over. A car accident lawyer can step in immediately after a denial to protect your rights and pursue the compensation you deserve.
The first step an attorney will take is to review any potential denial letter to understand the insurance company’s reasoning. Denials may be because of lack of documentation, disputed liability, or policy coverage issue. A lawyer can carefully examine your policy, the facts of your accident, and whether the insurance company was justified in denying your claim.
Next, your attorney will work to gather and strengthen evidence. These tasks may include securing medical records, police reports, witness testimony, accident reconstruction, or expert opinions. With stronger documentation, your lawyer can challenge the insurer’s denial.
If the insurance company refuses a reasonable resolution, a lawyer can file a lawsuit. Litigation creates significant pressure on insurers, as they now face legal costs and the possibility of being ordered by a trier of fact to pay significant damages.
Throughout the process, your attorney will handle communications with the insurance company, ensuring you do not say anything that the insurance company can use against you. They also adhere to strict compliance with legal deadlines, which is critical in preserving your rights. By challenging the denial strategically and aggressively, a car accident lawyer maximizes your chance of overturning the insurer’s decision and obtaining fair compensation.
Can I Mediate My Case or Negotiate When the Insurance Company Denies My Car Accident Claim?
Even if the insurance company denies your car accident claim, you can still resolve the dispute without immediately going to court. One of the most effective approaches is negotiation or pre-suit mediation.
Insurance companies often deny claims, hoping the claimant will give up. However, with the right strategy, it is possible to reopen discussions. Negotiation frequently involves presenting additional evidence, such as medical documentation, accident reconstruction reports, or witness statements, that addresses the reasons for denial. A car accident lawyer can lead these discussions, protecting your rights and ensuring the insurance company takes your case seriously.
Mediation is another valuable tool. This process uses a neutral third party to help both sides reach a settlement. Mediation can either occur pre-suit (before a lawsuit is filed) or in litigation, after a lawsuit is filed. Mediation is less formal and less costly than trial, allowing you more control over the outcome. It is beneficial when both sides want to avoid the uncertainty of a trial.
Whether through direct negotiation or mediation, a skilled attorney can frame the strongest arguments on your behalf, push back against unfair tactics, and work toward a fair resolution. While resolving every case outside the courtroom is not possible, pursuing mediation or renewed negotiations after a denial can save time, money, and stress—and may lead to the compensation you need without prolonged litigation.
How to Avoid Having the Insurance Company Deny Your Car Accident Claim
Insurance companies look for reasons to reduce or reject claims, but you can take proactive steps to protect your right to compensation. The first and most important step is immediately reporting the accident to law enforcement and your insurance company. Delays in reporting are one of the most common reasons insurance companies deny claims. Potential claimants are encouraged to speak to and retain a personal injury attorney before speaking to any insurance company or before reporting the claim. Your personal injury attorney should be able to report the claim for you, and deal with the insurance companies on your behalf, without the danger of you saying anything to an insurance adjuster that may be misconstrued or otherwise hurt your case.
Next, gather as much evidence at the scene as possible. Photos of the vehicles, road conditions, traffic signals, and visible injuries can provide key proof. Collect witness contact information and request a copy of the police report. These details can help establish fault and counter an insurer’s attempt to dispute liability. However, it can be challenging to gather evidence at the scene when you are dealing with physical injuries.
You should also seek prompt medical treatment, even if your injuries appear minor. Following a car crash, claimants must seek medical treatment within 14 days following a crash, or they forfeit their PIP benefits which pays a large portion of their medical care. Insurance companies often argue that delays in care mean the injuries were unrelated to the accident. Consistent medical records strengthen your claim.
Finally, consider working with a car accident lawyer early in the process. An attorney can communicate with insurers on your behalf, ensure you meet all deadlines, and present a well-documented claim that is harder to deny.
Why the Insurance Company Is Less Likely to Deny Your Car Accident Claim When You Have a Car Accident Lawyer
Insurance companies are businesses; like any business, they aim to minimize costs. That often means denying or undervaluing car accident claims whenever possible. When an injured person files a claim independently, insurers may assume they are unfamiliar with the process, legal deadlines, the potential value of the case, or the evidence required to prove liability and damages. Then, it can be easier for them to issue a denial or offer a low settlement.
However, the likelihood of denial decreases significantly when a car accident lawyer represents you. An experienced attorney understands insurers' tactics and knows how to challenge them effectively. Lawyers gather medical records, accident reports, witness statements, and expert testimony to build a strong case that is difficult for insurers to dismiss. They also ensure you file the paperwork correctly and meet all deadlines; two common pitfalls for self-represented claimants.
Insurance companies recognize that a represented claimant can file a lawsuit if they do not offer a fair settlement. This potential for litigation increases the pressure on insurers to handle the claim more seriously and fairly from the start.
A Car Accident Attorney Is Standing By
Having legal representation levels the playing field. It signals the insurance company that you understand your rights and will not accept an unjust denial. Hiring a lawyer greatly improves your chances of securing the compensation you deserve and avoiding unnecessary delays or disputes. With their guidance and support, you can feel more confident pursuing the compensation you deserve. Do not hesitate to contact a trusted attorney who can guide you through a denied car accident claim and fight for the justice you deserve. Call a Coral Springs personal injury lawyer at Cindy Goldstein Law at (954)346-5420 to discuss your case.
Car Accident Insurance Claim Denial - FAQs
Can I sue the insurance company directly?
Typically, you sue the other driver in a car accident case and can potentially sue your own insurance company in an uninsured motorist claim. Your personal injury attorney will evaluate who the lawsuit should be filed against and should discuss same with you.
What if the insurance company approves my claim but does not offer me what I think my case is worth?
If the insurance company accepts liability but is not offering you reasonable compensation, you can still fight back. Your personal injury attorney should discuss case value with you and the pros and cons of filing a lawsuit.
How long does it take to resolve a denied claim?
If a claim is denied, your attorney will evaluate with you whether to file a lawsuit. If a lawsuit is filed, the length of time is determined by whether the case is resolved at mediation, and/or the Court’s scheduling orders establishing strict deadlines. Often, litigation can take several years.