The aftermath of a car accident in New York can be devastating and stressful, and you may be left with substantial medical bills, vehicle repairs, and other expenses. Insurance should pick up these costs, whether it’s your own PIP provider or the company that issued the at-fault driver’s liability policy. So what do you do if the insurance company denies your claim?
Sometimes, insurers deny claims for legitimate reasons. Other times, they make mistakes or act in bad faith. Do not simply accept a denied claim, as there might be options to recover the compensation you need and deserve. Hire an experienced car accident lawyer to determine what to do next.
What Your Denial Letter Means
An insurance adjuster handles the claims process after you file your claim with the insurance company. The adjuster will conduct an investigation, speak to those involved in the crash, and review the available evidence. After analyzing the necessary information, they will determine whether to accept or deny the claim.
If the adjuster determines the insurance policy doesn’t cover the accident, they will send you a denial letter. The letter should contain the reasons for the denied claim. It should also include the options for arguing against the decision.
Sometimes, resolving the issue is simple. The adjuster might cite incomplete records as the reason for the denial, requiring you to submit the necessary documentation. In other cases, disputing the denial may be more complicated. Simply disagreeing with the decision without valid evidence of why you deserve compensation isn’t enough to fight the insurer.
Why Insurance Companies Denied Car Accident Claims
Many circumstances can lead to a denial. In the case of a liability claim, the adjuster might disagree with eyewitness statements or police reports and determine you caused the crash. Alternatively, there may be issues with your own PIP policy that lead to a denial.
The most common reasons for denied car accident claims include the following:
- Lapsed policy – Anyone registering a car in New York must obtain auto insurance. The policy should remain active to satisfy state requirements. That means paying the monthly premiums on time and in full. Missing a payment could lead to a lapse in coverage. If the insurance adjuster finds that you didn’t have insurance when the crash occurred, they can deny your claim.
- Fraud or misrepresentation – You might feel tempted to lie during the claims process to secure a more generous payout. However, submitting fraudulent forms or misrepresenting the facts of your claim won’t lead to a successful outcome. The insurance adjuster can deny your claim if they discover you lied about details regarding the crash. You could also face legal implications.
- Policy exclusions – Car insurance is crucial after a car wreck. It can cover your medical bills, lost wages, and other expenses. However, you should carefully review your policy to determine the available coverage. Exclusions might apply under specific circumstances. Those exclusions could prevent you from a settlement to compensate for your financial losses. For example, policies often exclude coverage if intoxication contributes to an accident. If you were under the influence of alcohol and caused the crash, your insurer likely won’t provide compensation.
- Missed deadline – Not all insurance companies impose strict deadlines for filing claims. However, if your insurance policy contains a timeframe for filing your car accident claim and you missed it, you will likely receive a denial letter.
- Incomplete or inaccurate details – You must complete a form and submit evidence to support your claim. Leaving out important details or providing the insurer with incorrect information can result in denial. Without the necessary documentation, the insurer can’t determine whether you are entitled to compensation under the terms of the policy it issued.
- Insufficient medical evidence – You must be able to show your injuries were caused by the car accident in question in order for the insurance policy to cover them. If the insurer believes an unrelated incident caused your injury, it will likely deny your claim.
- Bad faith – Insurance carriers must honor the terms of the policies they issue. When they do not, they are said to be acting in bad faith. Bad faith acts can include delaying the process unnecessarily, failing to investigate the accident, or misrepresenting the policy information. Although illegal, some insurers act in bad faith to avoid paying claims. When that happens, you can pursue legal action against them.
How to Appeal a Denied Car Insurance Claim
If you believe the insurance adjuster made a mistake or acted in bad faith, you can appeal your denied claim. Reversing the decision might be as simple as contacting the adjuster and explaining the situation. However, you can file an appeal if the insurer is reluctant to review your denied claim.
You should not pursue an appeal without a lawyer. Lawyers know how to communicate with insurance companies on behalf of clients. Unrepresented accident victims often get taken advantage of because they don’t understand their rights.
You will need evidence to support your appeal. Evidence can include eyewitness statements, additional medical records, photos from the accident scene, and traffic camera footage. If your initial claim is missing information, you can submit additional documentation during your appeal.
Once you’ve gathered the necessary evidence, you must draft an appeal letter. Your attorney can write one for you, more effectively arguing why the new information should overturn the initial denial.
Filing a Lawsuit Against an Insurance Company
If the insurer continues to deny your claim, you can proceed with a lawsuit. However, you must confirm you are within the required timeframe.
The statute of limitations on breach of contract allows a six-year timeframe to file suit. That means you have six years from the date your legitimate claim was denied to initiate your lawsuit against the insurer. If six years have passed, you won’t be able to sue.
Hurt in a Car Accident? Contact Finz & Finz, P.C.
Were you hurt in a car accident? Are you struggling to get the money you deserve? Then Finz & Finz, P.C. is here to help. For over 35 years, our legal team has fought for injured clients’ rights. We are ready to pursue the compensation you deserve. Call us at 855-TOP-FIRM for a free consultation with a car accident lawyer in New York.