It’s really tough facing the mounting medical bills and other losses after a car accident under any circumstances, and particularly when the other party’s insurance company is refusing to pay what you are owed. An injury attorney in El Paso can help you sort through this mess and bring all your legal options to bear to make the insurance company follow through on their obligations.
Legal Options When an Insurance Company Won’t Pay
There are basically two legal options you have in the face of an insurance company that’s refusing to pay. The first is to make a complaint with the Department of Insurance. What this will do is force the insurance company to be crystal clear about exactly why they are denying you your coverage, and it may push them to agree to a settlement. Your lawyer can help you to file this complaint in the right way and with the right people to put pressure on the insurance company that they will find hard to deny.
Your other legal option is to bring a lawsuit against the insurance company or against the other driver. A lot will depend on your unique situation, so you should talk to a lawyer as soon as you can about the specifics so your lawyer can help you figure out the best next steps.
What to Do Before Taking Legal Action
1. Contact an Injury Attorney in El Paso
Before you do anything, be sure to contact an attorney. You’ll be able to lay out all the specifics of your case to find out what your options are and how strong the case is. Once a lawyer takes over negotiations, the insurance company often starts negotiating in better faith. Getting a lawyer signals that you’re serious about defending your rights.
2. Go Over the Rejection for Simple Mistakes
Before you do anything else, sit down with your lawyer and go over the rejection from the insurance company to make sure there hasn’t been some sort of simple mistake that could be fixed with more evidence or a clarification. It may be that some of the evidence is missing, and the insurance company doesn’t have what it needs to sort out your claim or verify something you’re asking for. There could be something just as simple as the wrong policy number or the wrong name on the claim form.
3. Figure Out Exactly What They’re Saying
Assuming the mistake is not a simple error, the next step is to understand exactly what the basis is for their denial. While this will depend on your situation, there are some things that are fairly common:
Dispute Over Liability
If the other party in the accident is denying liability, their insurance company may refuse to pay. If this happens, you’ll have to provide definitive proof that the other driver is liable. Sometimes, the driver themselves is happy to admit that they caused the accident, but the insurance company finds a way to construe the evidence to claim that the driver they cover wasn’t responsible or wasn’t responsible to the degree they really were. Again, you will need definitive evidence of what happened so that you can prove fault, and your lawyer can make a clear case to the insurance company why the law will side with you on liability.
If you don’t have evidence, or if the evidence you have is not sufficient, your lawyer may be able to help you do an investigation that could turn up more. It’s possible there may be a security camera on a nearby business, for instance, which might have captured what happened. Or, the police report might have been filed inaccurately and accidentally switched your name with the other driver’s, in which case you would need to immediately get to work disputing this error and asking the police to correct it. Your lawyer will collect evidence for you and get to work on this right away.
Policy Exclusions and Limitations
Policy exclusions can be a nightmare to work with, and insurance companies love to look for them. Exclusions are special clauses within the policy that say the insurance company doesn’t have to pay under certain circumstances. If there’s a policy exclusion, your lawyer can help you to sort it out and to show why your case doesn’t apply.
Not Enough Coverage
Texas has laws that require a minimum amount of coverage for all drivers, but that minimum is really quite small. One of the most frustrating things that can happen after an accident is to start tallying up all your losses and damages and then fund that the driver’s insurance doesn’t actually have enough to cover everything. Texas requires $30,000 in liability insurance to cover the injuries to each person involved in an accident, up to a total of $60,000 per accident, and $25,000 to cover property damage. With a serious injury, medical bills can easily be far higher than $30,000.
If the insurance company won’t cover all your damages because of policy limits, your lawyer can help you to explore other avenues where you might be able to get compensation. This might include your own insurance company, a third party who might be partially responsible for the accident, or even a lawsuit brought against the primary responsible driver. Unfortunately, if a driver doesn’t carry a lot of car insurance, it’s usually because they don’t have the money to afford more, and that means they may not have the money to cover your losses and damages. But you never know, and it’s always worth talking to your lawyer.
Pre-Existing Condition or Other Rejection of Medical Records
Another common reason for an insurance company to deny claims is by arguing that the medical records and injuries you are seeking compensation for are not related to the accident, are not as serious as you claim, or are related to a pre-existing condition that they should not have to cover. It’s very important after an accident to get medical help as soon as you possibly can. The longer the delay between the accident and medical treatment, the more likely it is that the insurance company will argue your injuries are unrelated to the accident.
The insurance company cannot deny your claim because you have a pre-existing condition. Just because you might be injured more than another person would have been due to that condition does not make the other party any less liable. The law requires them to “take you as they find you” in these matters. But what the insurance company might do is argue that something you’re suffering is not actually caused by the accident but is rather the natural progression of your pre-existing condition. Your lawyer will help you to gather evidence to fight back against this and show what’s really happened to you.
It’s always difficult when an insurance company tries to deny your claim, but you do have options. A personal injury attorney can help you to explore all of them, so contact us now at Cesar Ornelas Law San Antonio, TX for help. We also have offices throughout Texas and in New Mexico and California, so call us today at (855) 710-4912 to start your free consultation.
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If you or a loved one has been seriously injured, please fill out the form below for your free consultation or call us at: (210) 957-2103
